Making female condoms
available and accessible
A guide on implementing female condom programs
Chapter 1. Process 12
1. Introduction: The complexities of female condom programming 12
2. Planning phase: Planning your female condom program 13
2.1 Preparation 13
2.2 Research 14
2.3 Formulating objectives and indicators 15
2.4 Program design 16
3. Implementation phase: Implementing and monitoring your female condom program 18
4. Evaluation phase: Evaluating your female condom program 20
Chapter 2. How to govern your female condom program 23
1. Introduction: How to build for responsibility and commitment 23
2. Operational team: Fruitful cooperation is the key to success 24
2.1 Lead organization 24
2.2 Community-Based Organizations (CBOs) 26
2.3 Peer educators 25
3. Installing a supervisory body 26
Chapter 3. Community approaches 28
1. Introduction: Female condom promotion requires subtlety and sensitivity 28
2. Working from within is the way to go 28
2.1 Civil society implementing partners 29
2.2 Private sector partners 31
2.3 Stakeholders in the public sector 32
3. Capacity building 33
4. Reaching out to the community: added value of implementing partners and peer educators 33
Chapter 4. How to communicate with potential users 36
1. Introduction: a carefully developed communication strategy is the key 36
2. How to determine your target audience(s) 36
3. Branding and rebranding the female condom 37
3.1 Rebranding: Is it worthwhile? 37
3.2 Branding campaigns 38
4. Messages 38
4.1 Examples of messages 39
5. How to communicate about the female condom 40
5.1 Inter-personal communication 40
5.2 Sensitization sessions 40
5.3 Edu-tainment: Road shows and drama performances 40
5.4 Drama performances 41
5.5 Visuals: Leaflets, posters and banners 41
6. Promotional materials and tools 41 10.1 Distribution free of charge 63
6.1 Developing material 41 10.2 Selling the female condom 63
7. Involving role models to convey your message 42 10.3 Sampling 63
8. Media for female condom promotion 43 11. Complementary approach 64
8.1 Media planning 44 12. Corporate Social Responsibility 65
8.2 Media channels 44 13. Female condom demonstration models 65
8.3 Monitoring 44
8.4 Capacity building of media and partnerships 44 Chapter 7. The involvement of men: It takes two to tango 66
9. Visibility 45 1. Introduction: What’s in a name? 66
10. Advantages and disadvantages of the use of different communication channels 45 2. How to use the media for promotional purposes 66
3. How to adapt your messages to attract men’s attention 67
Chapter 5. Advocacy towards decision makers 48 3.1 Using role models to spread the word 68
1. Introduction: Exerting influence to bring about positive change 48 4. Partnerships will contribute to your cause 68
2. What is advocacy? 48
2.1 Why is advocacy important? 48 Chapter 8. Creating demand, increasing access 70
3. Developing an advocacy strategy 49 1. Introduction: Team up and wise up! 70
3.1. Defining the issue 50 2. Partnerships with public and private sector players 70
3.2 Set overall goal and objectives 50 2.1 Non-commercial, not-for-profit 70
3.3 Identify Target Audience: advocacy towards the government 51 2.2 Commercial, for profit 70
3.4 Build support 52 3. Social marketing: Our good practice! 71
3.5 Develop your message 52 3.1 Four P’s 71
3.6 Channels of communication 53 4. Complementarities and collaboration 73
3.7 Raise funds 53
3.8 Develop your implementation plan 54 Annex 1: Focus Group Discussion Guide for current users and non-users of the female condom 74
3.9 Ongoing steps: Data Collection and Monitoring 54
Annex 2: Example of a Female Condom Program Goal and Objectives 77
3.10 Evaluation 54
Annex 3: Communication Strategy Outline 78
4. Creating conducive environment outside of the policy field 54
4.1 Community leaders and gate keepers 54 Annex 4: Outline of an Advocacy Plan 79
4.2 Donors and other institutions 55 Abbreviations 80
Bibliography and further reading 81
Chapter 6. Procurement and Supply Chain Management 58 Frequently Asked Questions 84
1. Introduction: Availability is key 58
2. What is procurement? 59
3. Shipment and customs clearance 59 Acknowledgements 89
4. Testing 59 Colophon 90
5. Wrapping and packaging 60
6. Storage 60
7. Transportation 61
8. Distribution through different channels 61
8.1 Community-level: Peer educators and CBOs 61
8.2 Pharmacies and drug stores 62
8.3 Non-traditional outlets 62
8.4 Public health system 62
9. Keeping Stock 62
10. Distribution 63
Nigeria Cameroon Zimbabwe Mozambique Foreword
Female condoms should be available, accessible and affordable, For these and other reasons, I am proud that the Dutch Ministry
because they are the only female-initiated method of protection of Foreign Affairs is a founding member of the Universal
against unwanted pregnancy and sexually transmitted Access to Female Condoms Joint Programme (UAFC). This
infections. The facts are, however, that the female condom is partnership aims to incorporate the female condom into regular
expensive, requires some instruction for use and is far from reproductive health programming, so that it will ultimately be
being readily available at every corner shop. just as common and accepted as the male condom or hormonal
The use and availability of the female condom is part of a
broader issue: the unmet need for family planning. According This Implementation Guide on Female Condom Programming
to UNFPA, at least 200 million women would like to use safe is an important and concrete result of the work of UAFC
and effective family planning methods, but have no access to and its partners. The Guide offers valuable information
information or services, or lack the support of their husbands about implementing female condom programmes, based on
and communities. This concern is even more pressing in the experiences in Nigeria, Cameroon, Zimbabwe and Mozambique.
light of women’s increasing vulnerability to HIV infection. It is a practical tool for current and future programmers
The issue of female condoms is also connected to the
Millennium Development Goals (MDGs), in particular MDG5, When the Dutch Ministry of Foreign Affairs joined the UAFC
which is aimed at reducing maternal mortality and increasing partnership, we were convinced that the female condom market
the accessibility of reproductive health services. Progress needed an innovative impulse. We felt this public-private
towards achieving MDG5 is slow. That is why I have made sexual partnership had the potential to make a difference in the areas
and reproductive health and rights (SRHR) − including HIV/AIDS of global health and human rights.
– one of my four policy priorities.
This Implementation Guide proves that supporting UAFC
Increased female condom use will also help to achieve MDG3 was a smart move. I congratulate our UAFC partners and the
(promoting gender equality and empowering women), MDG6 implementing agencies on this publication, and sincerely hope
(combating HIV/AIDS and other diseases) and the objectives set that it will help lead to available, accessible and affordable
out in the Programme of Action of the International Conference female condoms for all.
on Population and Development (ICPD).
Minister for European Affairs and International Cooperation
The female condom: We invite you to join our global effort! • Unlike with the male condom, the sex does not need to be Why is specific female condom programming necessary? It is evident that female condoms contribute to the variety
Imagine a contraceptive that offers women protection against interrupted: the female condom does not need an erection There is a desire to use the female condom, by both women and of contraceptive choices and address urgent sexual and
unintended pregnancy, HIV/Aids and other sexually transmitted and can therefore be inserted before sex. Furthermore, it men. However, female condom programming is more complex reproductive health problems, such as unintended pregnancy
infections (STIs), and which also enhances sexual pleasure for does not require immediate withdrawal after ejaculation. than that of, for example, male condoms. Since the female and sexually transmitted infections, including HIV/Aids. In
both themselves and their partner. This is the female condom! condom is a woman-controlled contraceptive, its promotion many countries, female condoms are not widely available.
Women and girls face the consequences of unprotected sex • Qualitative studies among women using the female condom may confront deeply rooted ideas about sexuality, gender This accounts for limited access, often exclusively through
and bare the huge burden of unintended pregnancy and the show an increased sense of power in negotiating safer sex equality and women empowerment. It is also more complex the public health sector. Introducing female condoms more
risk of infection, including HIV/Aids1. The female condom is and a greater sense of control and safety during sex 2. than programming other women-initiated contraceptives like widely needs truly large-scale programming in the sense that
the only contraceptive that offers dual protection against both • The female condom has no side effects and can be used the pill, because female condom use involves education on all different aspects of successfully introducing it into the
pregnancy and STIs, including HIV/Aids, and is available now. without seeking assistance of a healthcare provider. People sexual intercourse and the woman’s private parts. market are included, e.g. procurement of the female condom,
These are strong arguments in favor of wider availability and who are allergic to latex can still use the FC2, currently the That is why it’s most important to —first and foremost— focus supply chain management, promotion on community level,
programming of the female condom, but there are many more most commonly used female condom, because it is made of on normalization of the female condom. This will lead to media engagement, and advocacy. However, implementers
advantages: nitrile, a material that is just as reliable. demand creation. Consequently, it is of great importance to give should embed the program within existing policy frameworks
• Female condom use increases sexual pleasure: studies special attention to the female condom by organizing specific and programs, while working closely with government and civil
report a high satisfaction rate by both women and men programming around it. society5.
who have used the female condom. Men like it because the
female condom is not tight or restricting and they experience Specific large-scale female condom programming is important
more stimulation. Women like it because the female condom for several reasons:
is highly lubricated and the material heats up to body Bassomo William Isidore, motor taxi driver
temperature. 1. In most countries, female condoms are a largely unknown Douala, Cameroon, 5 November 2010
• Female condoms expand the contraceptive method choice. product: they are either not available at all or only in very “I prefer the female condom to the male condom. Sex is
Studies have shown that providing women and men different small quantities and are hardly marketed, if at all. New more natural with the female condom than with the male
options in using contraceptive methods increases the products always need special attention when they enter condom. It’s like you are getting into a women directly.
likelihood of contraceptive use3. the market: people need to know about it and need to know It was a bit difficult at the beginning but I am used to it
where they can get it. Without sufficient investment in now. My wife first introduced the device to me but now I
procurement and marketing of the product, components that am the one buying them. I spotted the posters advertising
Large-scale female condom programming is lagging behind are both part of the large-scale programming that is being the female condom in the shop here so I stopped my bike
Despite these convincing advantages, globally, female condoms advocated for in this guide, this will remain as it is and will and asked if I could buy them here. Ever since then, I
are still not widely programmed on a large scale. This is not further restrict the growth of demand. In other words: large- have come back here to buy female condoms. The male
to say that female condoms have never been programmed: scale programming is needed for demand creation. condom does not interest me anymore because it restricts
female condoms have been made available to specific target 2. Despite their importance, female condoms are not an easy movement during sex.”
groups in the past, most notably to female sex workers. There product to sell. Female condoms are used for sex. More
is a high satisfaction rate among these specific groups and we particularly they are designed for women having sex. And
need to continue to make the female condom available to them. they give women more control over the protection of their An implementation guide on female condom programming
However, we believe that the female condom is a contraceptive bodies. As all of this is a taboo in many societies, the product This Implementation Guide on Female Condom Programming
method that benefits all people who are sexually active, in needs to be marketed carefully. aims to facilitate the expansion of large-scale female condom
terms of sexual pleasure and family planning as well as HIV/Aids 3. Closely related to the first two: many myths and programming worldwide, so that the female condom will be
prevention. Women who have a high risk of infection with HIV4 misconceptions about the female condom exist, often due available, accessible and affordable for all women and men.
within their marriage can highly benefit from using a female to ignorance about the product. These need to be countered This guide is written for (potential) implementers of large-scale
condom and from being able to negotiate its use with their by continuous positive and accurate messages about the female condom programs of national and international NGOs,
partner. For couples that want to plan their families, the female benefits of female condom use at all levels of society. CBOs, donors, health practitioners, and other professionals in
condom is a reliable contraceptive method. People living with 4. When encouraging the use of the female condom and the field of health, sexual and reproductive health, HIV/Aids
Female Condom FC2 HIV/Aids can trust the female condom in avoiding transmission, increasing its acceptance, it is very important that women prevention, and gender.
and can therefore enjoy having sex without worries. and men receive accurate information and education about
• The female condom is a women-initiated contraceptive, the female condom in a safe environment. The use of the This Implementation Guide represents the experiences, lessons
which means that women are in control when they use them. The female condom is more expensive than the male condom, female condom is not self-explanatory and inter-personal learned, challenges and successes of the female condom
The use of male condoms often has to be negotiated over although larger-scale production could lower the price communication explaining its proper use is therefore vital to programs of our colleagues in Cameroon, Nigeria, Mozambique,
and over again, often in the form of an interruption during over time. Compared to life-long HIV/Aids treatment or the its success. Also, the first time one uses the female condom, and Zimbabwe. Zimbabwe currently has a successful female
sex. Female condoms have to be negotiated only once. Once consequences that an unintended pregnancy may have, the insertion may not be smooth. Like with the male condom, condom program, which was initiated approximately fifteen
the male partner agrees to use it, the woman can insert it female condom is in fact very cost-effective. using it takes a bit of practice. Women need to be able to ask years ago. In Nigeria and Cameroon, large-scale female condom
each time before sex. No action is required from the man. questions to peer educators about the female condom and programming was initiated in 2009 as part of the Universal
get support to use it. Access to Female Condoms (UAFC) Joint Programme, and in
1 In Sub-Sahara Africa, 60% of people infected with HIV are women. UNAIDS (2010), Report on the Global Aids Epidemic, page 30.
Mozambique it was kicked off only recently. These programs
2 Gollub EL. The female condom: tool for women’s empowerment. American Journal of Public Health 2000;90(9):1377–81.
3 Fontanet AL, Saba J, Chandelying V, et al. Protection against sexually transmitted diseases by granting sex workers in Thailand. the choice of using the male or female condom: results from a randomized
controlled trial. AIDS 1998;12(14):1851–59.
4 In Sub Sahara Africa HIV transmission often occurs within marriage: In Zambia 60% of the people newly infected are infected within marriage or cohabitation. In Swaziland this is 50%–65%, and in Kenya an 5 The Comprehensive Condom Programming (CCP) Rapid Need Assessment and Strategic Planning Tool of UNFPA can guide implementers in integrating condom programming in existing policy frameworks.
estimated 44%. UNAIDS (2010), Report on the Global Aids Epidemic, page 30. http://unfpa.org/webdav/site/global/shared/documents/publications/2011/CCP.pdf
are being implemented in very distinct contexts and have been In Nigeria, Victoria, Ifeoma, Mimi, Jennifer, May and their How to use this guide? should aim for modest targets: in the first year you will need to
adapted accordingly. Each program has generated new ideas colleagues at Society for Family Health (SFH), Girls’ Power This guide will offer you the opportunity to get a comprehensive invest in the program’s structure. You may increase your targets
and insights regarding what it means to conduct female condom Initiative (GPI) and Lift Above Poverty Organization (LAPO) overview of all different aspects of large-scale female condom once your program has been running for a while.
programming successfully. and many others work around the clock to encourage female programming. The guide is however structured such that you
condom use to a wide audience. In less than three years (2008- can pick and choose the themes that are particularly relevant It is most important that donors, governments and communities
The female condom programmers who worked hard to collect 2011), the number of Nigerian sales points that sell the female for you to learn more about, depending on the context in which notice the effectiveness of female condom programming,
their knowledge and experiences to be shared with you in condom has increased from 3% to 45% in Edo State alone7. you are implementing your program. It is important to note that realize that demand for the product exists once people become
this guide, are all very passionate about the female condom. This is perfect proof that female condom programming is able this guide discusses steps and lessons learned, assuming that acquainted with the product, and come to regard the female
They know first hand of the problems that couples face when to account for an enormous increase of access to the female funding has been secured already. Hence, fundraising is not condom as complementary to the other available contraceptive
expressing their sexuality, planning their families, protecting condom in only a short amount of time. discussed here. choices. Ultimately, it is your goal to make the female condom
themselves against unintended pregnancy and Sexually accessible, available and affordable for all. Hence, repeated and
Transmitted Infections (STIs) including HIV/Aids, and when In Zimbabwe, Patience, her supervisor Kumbirai and the care sustained use is key. The strategies that are being discussed in
attempting to have pleasurable and consensual sex. On a daily Initiative team of PSI Zimbabwe work hard to keep up the this guide will help you to achieve this.
basis, they experience people’s curiosity with regard to the good work that they have been doing for over fifteen years. Mercy Odiase, HIV positive women, 39 years, trader in bags
female condom. Many people want to try it and, once they do, Zimbabwe has had a female condom program since 1996, in Benin City, Nigeria, 3 November 2009
they often love it! At the same time, (potential) users have many which it teams up with the government. Clearly, the social “HIV positive women can have sex again. I myself have Let’s make a global effort!
questions and concerns about female condom use. Female marketing female condom program8 in Zimbabwe is bearing its tried it. As a positive woman I must use one. But I also The implementing organizations involved in this guide have
condom programmers often work in environments where there fruits: female condom sales have increased from 120,720 to 2.1 advise others to do so. I talk about it with my friends. aimed to document and share their experiences with current
is aversion, even outright hostility, towards the female condom million between 1997 and 2010. PSI Zimbabwe has trained over Without the condom the diseases would spread too fast and future implementers of large-scale female condom
as a contraceptive method, because openly discussing sex - and 2000 hairdressers and barbers since the inception of the Hair and young girls get pregnant. There is a huge need for this programs, so that more women and men around the world will
women’s sexuality in particular - is taboo. This makes female Salon Initiative in 20029. The female condom is also distributed female condom.” have access to the female condom. All who have contributed are
condom promotion difficult and exciting at the same time, which to over 105 sex worker groups and over 50 people living with convinced of the great potential that female condoms have in
only strengthens our devotion to our cause: there is an urgent HIV (PLHIV) support groups. offering women and girls the opportunity to protect themselves
need for female condom promotion so that more people will The guide starts off with a general chapter that outlines all against unwanted pregnancy and Sexually Transmitted
know of it, accept it, and have access to it. In Mozambique, three organizations—PSI Mozambique, aspects of female condom programming from start to finish. Infections (STIs), including HIV/Aids. We sincerely hope that this
Fórum Mulher and Pathfinder International–are in a unique This chapter is followed by seven thematic chapters that guide will help you in contributing to the expansion and success
In Cameroon, Lily Claire Ekobika and Hervé Roger Ngueche consortium to jointly implement a large-scale female condom further extrapolate on the distinct aspects of female condom of large-scale female condom programming worldwide. Let’s
of Association Camerounaise Pour le Marketing Social (ACMS) program. This is paying off: all three organizations bring in their programming: make the female condom available, accessible and affordable
and their colleagues work with hairdressers, civil society-based own expertise, which contributes to the success of all aspects • Governance: how can your program be governed effectively? for all!
organizations and media to promote the female condom as a of the program. Dorien, Maira, Margarida, their colleagues and • Community approaches: how to reach out to potential users
reliable family planning tool to both men and women. Because their organizations are very devoted to introducing the female within the communities?
of them, and all of their colleagues and partners, 773,321 female condom to the people of Mozambique. • Communication: what are the different communication
condoms were sold in Cameroon in 2010 6 , less than two years methods to educate, inform and communicate about the Mercy Aigbe, traditional midwife
after the start of the large-scale female condom program. These female condom programmers in Cameroon, Nigeria, female condom? Benin City, Nigeria, 2 November 2009
Mozambique and Zimbabwe face some of the same challenges, • Advocacy for female condom promotion: how to set up an “I help women deliver their children. Women are having
but also very different ones, depending on the setting in which advocacy strategy and work towards creating a supportive too many children here. Every year the women come
they work. Most importantly, all of them have a passion for the environment for female condom promotion? back with another child. The female condom can give
female condom and sincerely believe that female condom use • Procurement and supply chain management: everything us the space. Space to not have children in too quick
ultimately improves couples’ sexual and reproductive health. about purchasing, shipping, storing, and distributing the succession! You prevent pregnancies; you can practice
Their experiences are included in this guide, so that their female condom. family planning. I’m all for using them.”
stories will help you anticipate challenges and opportunities • Male involvement: strategies to reach out to men in female
as best as you can when implementing a large-scale female condom promotion.
condom program. • Creating demand, increasing access: how to create demand
and increase access to the female condom by strengthening
the different sectors?
Elvis Oviasuyi, pharmacist
Benin City, Nigeria, 2 November 2009 Let’s be realistic!
Aunty Queen Beauty Salon in Buea, Cameroon. Mama Odilia selling “We use it because we think it’s fun, but it also comes in In female condom programming, it is important to set realistic
female condoms in her salon handy in family planning. We have three children, still goals for yourself. Most often, the female condom is a relatively
young; that’s plenty for us.” new and unknown product. This means that it will take some
time before people get to know, try and use it. Large-scale
female condom programming benefits the entire sexually active
population. However it is recommended to start off by focusing
6 ACMS UAFC Joint Programme Annual Narrative Report 2010.
7 SFH 2011: Report of the 2011 MAPS Study on the Availability of the Female Condom in Lagos, Edo and Delta states. on several specific regions, or even simply by piloting a small-
8 At the same time, there is a national condom program through the public sector. In 2009, a total of 4.7 million female condoms were distributed through both the public and social marketing channels.
9 Center for Health and Gender Equity. Female Condoms and U.S. Foreign Assistance: An Unfinished Imperative for Women’s Health. Washington, DC: Center for Health and Gender Equity, 2011, page 37.
scale version of the envisioned program. In the beginning you Educational material FSH, Nigeria
Chapter 1. Process
Process: Planning, implementing, monitoring and evaluating 1. Introduction: The complexities of female condom 2.Planning phase: Planning your female condom program10 implementing organizations and target group(s) to involve in
your female condom program programming your program. Additionally, it is at this time that you will start
In this guide, we aim to describe in detail all the different When it comes to the design, planning, implementation, 2.1 Preparation with the procurement and supply chain management of the
elements of female condom programming. This chapter monitoring and evaluation of a female condom program, it does This phase precedes the very first planning of your female female condoms, as this process tends to be very tedious and
will outline the design and implementation of your not necessarily require you to follow an intrinsically different condom program. At this time, you will establish your project may take many months to execute effectively.
female condom program step by step, from planning to process from the one that you would use in other programming. team and supervisory body. You will also conduct a thorough
implementation and from monitoring to evaluation. The Nonetheless, the multifaceted nature of female condom stakeholder analysis, which will help you to determine which
order in which the process is presented by us here is not programming tends to make it a bit more complex. Female
necessarily chronological. We merely mean to give you an condom programming is twofold. On the one hand, it focuses
overview of possible timelines as well as necessary steps. on increasing acceptability and encouraging normalization
We aim to be as realistic as possible in the time frame of a stigmatized product. On the other, it should make sure to Planning phase: 1.1 Preparation
that we offer you. Nonetheless, it is important to note that facilitate proper procurement and supply chain management
each female condom program is unique and will have its to ensure reliable access to the product. These represent two Preparatory activity Explanation Time frame11
own unique features that will sometimes greatly impact very different levels that female condom programming should
progress—positively as well as negatively. Some steps both emphasize. Both are complicating factors that have an Mapping the needed The operational team needs expertise in: 2 months
discussed in this chapter, and in this guide in general, influence on how the program should be designed and require expertise in your
will be generic for all female condom programming. Other you to work with as many stakeholders as possible in order operational team Advocacy – Data collection and documentation - Project management –
steps will be specifically relevant for some female condom to maximize impact. Additionally, large-scale female condom Research – Procurement and supply chain management – Communication
- Report writing and financial management - Material development
programs, but not for others. In order to provide you with programming is new to most countries. Hence, it is important
(communication and promotional) - Community mobilization - Capacity
the full overview, we have assumed that your organization to set realistic goals for yourself and to emphasize proper
building / training - Fundraising12.
is starting from scratch. We have also assumed that funding monitoring and evaluation in order to convince government,
to design and implement a female condom program has been donors and communities of the importance of female condom
Involving relevant In order to get the necessary support to implement your program, consulting 4-6 months
secured already. Hence, fundraising is not addressed here. programming. relevant stakeholders and initiating a dialogue with them at an early stage is
Also, the amount of funding available to you will largely very important. Relevant stakeholders may include: Government (national and
determine the choices you may make with regard to the local government) – UN agencies - Private sector companies - Gate keepers –
design and implementation process. Community leaders - Support groups.
Lilian Tamako, 25 years old, student nurse
Bamenda, Cameroon, 2 November 2010 Establishing a supervisory Mapping relevant members, approaching them, agreeing on roles and 4-6 months
How did you first learn about the female condom?
“I tried it for the first time about four years ago. I did not Involving the target Planning meetings and advocacy visits with, for example: 3 months
like it very much at that time but later I realised that I group(s) Men and women who are sexually active, groups that represent specific target
bought the condom without really knowing how to use it. groups like women associations, transport workers, out-of-school male and
After that first experience I didn’t see the condoms for a female youth, men and women in unions, people living with HIV (PLHIV),
while. Last year all of a sudden they were back. I met a female sex workers and their clients, men and women in uniform, mobile
workers and their partners.
group of peer educators at the market talking to a group
of women. I stopped to listen. They demonstrated how
Procurement and Supply The procurement of the female condoms needs to be ensured before the 6 months
to use it and so I learned. After that I tried it again and it
Chain Management (PSM) project is rolled out. Usually during the first 6 to 12 months, the program will before the
was a lot easier for me.
of female condoms work with generic female condoms13 while awaiting the arrival of your own start of project
branded female condoms for social marketing purposes. Please note that it is implementation
So I would say that my first experience was not really important to involve the relevant national regulating body in this process to be
good but the second experience was different because of sure to work according to local laws and regulations.
the educators and so I learned to like it.”
Total time frame 6-12 months
Demonstrating the female condom on the market in Nigeria
10 Please note that the order in which the different steps are presented do not necessarily imply chronology. Furthermore, the list of steps is not exhaustive and the relevance of the different steps depends on
the context in which you will be implementing your program.
11 We have aimed to estimate the time frame needed as realistically as possible, based on the experiences of our implementing partners in four different countries. Nonetheless, the time needed to execute
the different steps may vary greatly from context to context. Activities can run simultaneously.
12 Even if your program is fully funded already, it makes sense to continue to raise funds for additional projects or the continuation of the program once the project phase has come to an end.
13 By referring to “generic” female condoms, we mean the type of female condom that is carrying the manufacturer’s brand. In the case of the FC2 this refers to the FC2s that have been branded by the Female
Health Company. In most cases, female condom programming will start off using whatever type of female condom is already available in the country, in warehouses or in the pipeline. These need to be
promoted and sold first before procuring new stocks.
2.2 Research is important to understand the broader context including the 2.3 Formulating objectives and indicators
Prior to designing your program, it is extremely important to service delivery system, socio-cultural environment, as well as Based on the outcomes of your needs assessment and
conduct thorough research on the current situation in your the political context. Furthermore, a mapping of existing policy situational analysis, you can start designing your program
country in relation to HIV/Aids, STI prevalence, unintended frameworks and implementation activities needs to be done in framework. What is the ultimate goal of your program? And
pregnancy rates, sexual and reproductive health, contraceptive order to avoid working in isolation and to ensure the best fit of what are the specific objectives?17 These may be supported by a
use, and target groups. Before starting your program, you need your female condom program within the larger framework. log frame that lists outputs, outcomes, objectives and indicators,
to gain insight into the need for the female condom of potential methodologies, and strategies.
users within different target groups, to what extent they Your research and data collection should be based on:
may have access to sexual and reproductive health services
already and the kind of information and contraceptives that • Needs assessment, situational analysis (primary data Planning phase: 1.3 Formulating objectives and indicators
are already available to them. A proper situational analysis collection)
will offer legitimacy to your female condom program and helps • Literature review, policy review (secondary data collection) Formulating objectives Explanation Time frame
you to gain insight into who you should target. In addition, it and indicators activity
Developing your program Your program plan describes the justification of the program, its duration, 3 months
Planning phase: 1.2 Research
plan planned activities, expected outcomes, division of responsibilities, and budget
lines. The development of your program plan should be a participatory process
Research activity Explanation Time frame that involves all stakeholders and implementing partners.
Primary data collection14 Your primary data collection will significantly contribute to the 4-8 months Developing a logical A logical framework/dashboard is a planning, monitoring and evaluation tool 1 month
justification of your female condom program: it will argue in favor of framework/dashboard that requires you to describe the overall goal, outputs, outcomes, objectives
your program’s contribution to improving sexual and reproductive and indicators, and means of verification of your program.
health, family planning options, HIV/Aids infection rates, and the gender
situation in your country. This will legitimize your overall program design.
Total time frame 4 months
Your situational analysis15 should include:
Female Condom Coverage Survey
A coverage survey to measure:
1. Current availability of the female condom in outlets and public health
clinics, indicating the access to the female condom.
2. Quality of the current availability: in terms of quality of the outlet/public
Cypra Yamsu, Young Job Seeker, Regular User. Buea,
health clinic, supply and stock outs, availability of promotional and
educational materials and the price of the product, indicating the quality of Cameroon, 5 November 2010
access to the female condom.
Cypra, have things changed for you since you started
Your needs assessment should include: using the female condom?
“I can tell you that things have changed a lot. I have
A KAP/KAB study16 assessing the target group’s / groups’: actually had a wonderful experience using the female
• Knowledge about the product, availability / where to obtain the product, condom. I can actually protect myself and be very sure
and knowledge on how to use it. of such protection. I’m confident telling other women
• Attitude, including perception, behavior, motivation, acceptance, enabling about it.”
environment, and social support.
• Practice/Behavior addressing the level of use of the product.
Had both of you been using the male condom before?
“No. Our sex life was not really good because he never
Secondary data collection This desk study consists of an analysis of existing programs and policies that 1 month
liked using condoms. For that reason I was never really
address female condom use, sexual and reproductive health, family planning,
and HIV/Aids prevention. Some governments have national condom strategies. interested in sex because he travels a lot and I am not Educational material FSH, Nigeria
This analysis will help in integrating your female condom program into sure what he does when he travels and things like that.
existing policy and program frameworks in order to increase your program’s As a matter of fact, one time the male condom burst
sustainability. and I was scared and traumatised for months! But
since we started using the female condom nothing like
Total time frame 4-9 months this has ever occurred and so I am now comfortable
with sex again.”
14 If sufficient funding for a KAP/KAB and Coverage study which is more comprehensive is not available to you, market research is also an option for the socially marketed female condom in order to get
information concerning Willingness to Pay, user profiles, brand positioning, and segmentation by way of e.g. a focus group study combined with in-depth interviews. This will help in structuring your
communication strategy and marketing plan. This research can be executed by the lead organization itself, or a local/national (market) research firm or consultant may be contracted.
15 Refer to Bibliography and Further Reading for situational analysis tools.
16 See Annex 1 for Focus Group Discussions Guides with current users, and current non-users of the Female Condom. 17 Refer to Annex 2 for an example of female condom programming goal and objectives.
2.4 Program design
After the first round of preparatory activities, you may start
designing your program starting from the goal and objectives
that you have formulated.
Planning phase: 1.4 Program design
Program design activity Explanation Time frame Developing promotional Promotional materials20 may include: leaflets, posters, flip charts, training 3 months
materials and training aids manuals and guides. Modules should be developed based on the following
Baseline study A baseline study will help you to assess the current situation in relation 2 months behavioral determinants:
to your specific objectives. In the monitoring and evaluation of your • Knowledge: about the female condom and how to use it properly;
objectives you will then be able to demonstrate improvement that you may • Social influence: social acceptance and how to attain it;
claim as a success of your program. • Attitude: how to develop a positive attitude to avoid and address
misconceptions about the female condom;
Baseline studies may include: • Skills: how to use the female condom and how to negotiate condom use.
• Multiple Indicator Cluster Surveys (MICS)18;
• Household surveys; Promotional materials should be pre-tested with your target group(s). Make
• Demographic and Health surveys. sure to allow sufficient time for this process.
Annual (and quarterly) Based on your program plan, specific work plans need to be written 1 month Monitoring and Evaluation Your monitoring and evaluation plan needs to describe your program’s 1 month
work plans explaining the activities that you have planned, the estimated timeline, (M&E) plan and tools objectives and indicators and how these will be monitored. It should
budget, and how the activities relate to the overall goal and objectives of also describe the outcomes of your baseline study, a mid-term review (if
your program. applicable), an end evaluation, and should provide monitoring tools21.
Selecting and building CBOs, lead trainers and peer educators are selected based on their skills, 2-3 months Advocacy strategies and Creating a supportive and sustainable environment for female condoms 1 month
the capacity of CBOs, lead capacity and geographic locations. Memorandums of Understanding sustainability requires advocacy strategies that target the right influential people with
trainers, peer educators (MoUs) should be signed with selected CBOs. convincing messages22. Their support is needed for your program to be
implemented successfully, but also for the integration of female condom
Marketing plan, including The marketing plan is based on research, often carried out by an external Developing the programming into existing programs and policies.
communication and marketing firm. marketing plan: 2
branding strategies months Key stakeholders may be offered a seat in your supervisory body.
Marketing19 is about the following elements:
• Branding: it creates appeal and assures quality; Registration process Procurement and Supply Supply chain management is about effective distribution of female International
• Price: an attractive price is an incentive, both for the buyer and the needs to commence Chain Management (PSM) condoms from state level, to community level, and to outlets. Your PSM procurement should
seller; at least 6 months plan plan should describe the procurement, packaging, testing (if applicable), be sorted out at
• Placement: is about getting the product at the right place and the prior project and transportation. least 6 months prior
right time by way of effective distribution channels and supply chain inception so as to to program roll-out.
management; avoid delays when
• Promotion: promoting the female condom increases uptake and allows securing approval Documentation tools To capture lessons learned and to document the process properly, 1 month
for knowledge to be shared. for branding. documentation tools need to be in place for the lead organization to keep
track of program documentation.
Communication strategies towards the user may be part of your marketing
plan. Alternatively, they may be developed separately based on data on Total time frame 6 months
the profile of the target group(s), languages used, communication channels
used, literacy level, and what messages you want to communicate to
18 MICS are a tool for collecting and analyzing data in order to fill data gaps for monitoring the situation of children and women by way of an international household survey. 20 Refer to chapter 4: How to communicate with potential users.
Please refer to: http://www.unicef.org/statistics/index_24302.html 21 Refer to Bibliography and Further Reading for M&E tools.
19 Refer to the chapter 4: How to communicate with potential users and chapter 8: Creating Demand, Increasing Access. 22 Refer to the chapter 5: Advocacy towards decision makers and Bibliography and Further Reading for more information.
3. Implementation phase: Implementing and monitoring running according to plan. Needless to say, there should be a Advocacy towards Advocacy is a process that aims at generating support, promotion Developing your advocacy
your female condom program close link between implementation and the program’s overall decision makers and funds for your female condom program by attempting to strategy: 1 month
goal and objectives. Hence, assessment of your strategies strategically influence decision makers, such as community leaders
When all preparatory work is done and your program has been and time frame is essential to make sure that you are on the and other gatekeepers, government officials, and institutions. Advocacy activities: ongoing
properly designed, implementation of the activities may start. right track. A feedback loop should be created that allows A positive attitude towards the female condom and its benefits
You can choose to first pilot the program in a specific area, for changes and improvement in the project cycle. A proper therefore needs constant sensitization and engagement of influential
which you go on to evaluate. Based on the lessons learned you reporting system will contribute to your data collection and leaders in society.
may expand the reach of your program implementation. improvement of the overall program. Monitoring is done
through regular supervisory visits on implementation level and Procurement and The female condom needs to be available for the user. Procurement Procurement: as of 6 months
While implementing, your program needs to be closely should entail the collection of both qualitative and quantitative Supply chain and Supply Management is about purchasing the female condoms prior to the start of program
Management (PSM) from the manufacturer, shipping them to your country, storing them implementation
monitored to oversee whether or not the interventions are data.
in warehouses and depots, and organizing the logistics to get the & ongoing
female condoms to outlets, CBOs and peer educators. The “pipeline”
must be stocked at all times, meaning that all channels in the supply
Implementation phase23 chain (warehouses, depots, outlets, peer educators and CBOs)
should be permanently stocked. This means that you will need to
Implementation or Explanation Time frame purchase more products than you are expected to sell or distribute.
monitoring activity Distribution can be done in several ways: free distribution, giving
samples, selling subsidized products, or selling at a profit.
How to govern your Implementing a female condom program requires a solid governance Supervisory body meetings:
female condom structure that includes stakeholders who represent and have access every 3 months The involvement of Involving men in sexual and reproductive health matters has Ongoing
program? to different groups in society. The governance structure may consist men advantages over exclusively focusing on women, e.g. the genuine
of an operational team (lead organization, CBOs, peer educators) and Review meetings with lead protection of the couple and the family will be encouraged, respect
a supervisory body that oversees the overall program. organization, CBOS, lead trainers for the woman by the man will increase, gender equality will be
and peer educators: every 3-6 promoted, and a higher acceptance of the product by both men and
months women will likely be achieved. Hence, promotional events should
reach out to men and women equally.
Community Promoting female condom use requires collaboration with Training-of-Trainers for lead
approaches individuals that are part of the communities that you are targeting, trainers and CBOs takes place for Creating demand, There are different ways to promote the female condom to women Ongoing
so that they may invest in educating, counseling and selling the a total of 3-5 days. increasing access and men. There is the non-commercial or public sector that makes
female condom to potential users. These individuals may be found the female condom available in public centers like clinics, family
by consulting with civil society implementing partners, private sector Training of peer educators: planning centers, HIV/Aids voluntary counseling and testing centers,
partners, and public sector partners. Their competencies with regard 1-2 days. and by some NGOs/CBOs. Additionally, there is the private sector
to educating about and demonstrating female condom use should be that sells the female condom for a profit and is often based on
built. Review meetings with lead rebranding campaigns to attract the consumer. Finally, there is
organization, CBOS, lead trainers the social marketing approach that creates access by offering the
and peer educators: every 3-6 product for a subsidized price or by giving out free samples. The
months. different sectors complement each other in creating access to the
How to The (potential) user of the female condom needs accurate messages Peer educators start their
communicate with about the female condom and its use as well as the skills to try promotional events soon after Monitoring Coverage survey: The availability and quality of availability of the Annually
potential users? and use it. The user needs to be identified as the target audience. their training is finished. product should be monitored in order to assess impact.
Different target audiences may be reached through a range of Every 3 months
communication strategies, such as sensitization meetings, inter- Engaging role models: Reporting: Different stakeholders will report on their specific
personal communication by a peer educator, road shows, use of 6 months activities that are related to the program outputs and outcomes. A 2 months
media channels and handing out leaflets. The peer educator needs proper reporting format will help you to make sure that you collect
promotional tools such as a vagina demonstration model, posters, Developing media messages: the most relevant information from all stakeholders, so that you may
flip charts, and samples of the female condom. Rebranding the 1 month timely adapt your program indicators and activities.
female condom may attract more users.
Engaging media: ongoing Mid-term review: When project implementation is halfway, it is
Media plays a role in generating positive attitudes of the general helpful to assess your achievements to find out whether objectives
public towards the female condom by disseminating accurate, Training journalists: 1-2 days and indicators are realistic or need adjustments.
positive and attractive messages. Characteristics of a media
strategy include: developing messages, engaging role models in the Workshop with media directors: Total time frame Depending on your program’s
promotion of female condom use, and building the capacity of media 1 day overall duration
staff to convey correct and consistent messages.
23 The elements in the program design are thoroughly described in the thematic chapters that follow. 24 Refer to Bibliography and Further Reading for M&E tools.
4. Evaluation phase: Evaluating your female condom
When your program is coming to an end, an extensive
evaluation will help to assess whether your program
interventions have actually contributed to the overall goal
and objectives that you stated. Evaluation outcomes may
also provide you with a rationale for the continuation and
sustainability of the program as is or, alternatively, will offer you
suggestions with regard to how to adapt your program in order
to make it more effective and to attract new or more funding.
Phase 6. Evaluation
Evaluation activity Explanation Time frame
End Evaluation At the end of the program, achievement of program goal and objectives should 3 months
be evaluated. Your end evaluation may offer you suggestions for adaptations of
the program, or will legitimize a call to continue your program.
Total time frame 3 months
Paper dolls in front of the United Nations
in New York
20 Promotional materials UAFC Joint Programme 21
Chapter 2. How to govern your female condom program
Implementing female condom programming requires A good way of building a varied stakeholder base is by
a governance structure that includes stakeholders including them in the program governance structure. This will
who represent and have access to different groups allow them to meaningfully participate in advising on and/
in society. The operational team is responsible for or implementing the program. Giving them a stake in decision
program management and the monitoring of program making will generate a sense of ownership and will encourage
implementation on community level. The supervisory active engagement. Getting these stakeholders on board and
body is responsible for advising the operational team and work together is a complex process. However, once all different
should ideally advocate for the female condom among parties have been found willing to cooperate, this will maximize
their constituencies. This chapter describes the roles and female condom acceptance at different levels and among
responsibilities of the operational team—including the different groups in society.
lead organization, the CBOs, and peer educators—and of
the supervisory body. Design of your governance structure will depend on the
specifics of your program and political context in which you are
working. Nonetheless, there are some good examples of existing
1. Introduction: How to build for responsibility and female condom program governance structures. We will share
commitment these with you in this chapter while we discuss the different
Successful female condom promotion requires the on-going partners and stakeholders that may be part of your governance
support of a broad range of stakeholders in order for it to structure, the way in which they may relate to one another, and
become accepted by government, community leaders, other what particular opportunities and challenges are that you may
gatekeepers, CBOs, peer educators and, ultimately, potential encounter in the process.
users. Getting a broad range of stakeholders on board will help
you to gain access to their varied constituencies and will allow
you to reach out to as many people as possible that may benefit
from using the female condom.
Region 1 Region 2 Region 3
Regional Team Regional Team Regional Team
Lead Organization CBO’s Lead Organization CBO’s Lead Organization CBO’s
Peer Educator Peer Educator Peer Educator
Regional Regional Regional
Supervisory Body Supervisory Body Supervisory Body
22 Demonstration of female condom use in Nigeria 23
Case Study Mozambique
2. Operational team: Fruitful cooperation is the key to As a collective, the operational team should have joint
success expertise in communications, procurement and supply chain
The organizations and individuals that will actually implement management, social marketing, Sexual and Reproductive Health In Mozambique, the three organizations including Fórum • PSI/Mozambique is experienced in supply chain
your female condom program on a daily basis are key in your and Rights (SRHR), Family Planning, HIV/Aids programming, Mulher, Pathfinder International and PSI/Mozambique have management, and social marketing.
governance structure. They are the ones that coordinate, train, women’s empowerment and women’s rights, financial and been collaborating with the Female Condom Consortium to
advocate, supply and reach out to users. The operational team program management, and advocacy. implement a large-scale female condom program. During While PSI/Mozambique is the lead organization in the
may consist of the following organizations and individuals: the initial phase of the writing of the proposal, these three Consortium, implying that it carries the main financial and
• The lead organization(s) that coordinate(s) your program. organizations came together because they complemented each reporting responsibilities, the responsibility concerning the
The lead organization(s) may have regional teams or offices 2.1 Lead organization other’s expertise in a very effective manner: implementation of the different components was allocated
for the purpose of overseeing regional activities. The lead organization is responsible for the operational design, to these three organizations according to their expertise. In
• Community-Based Organizations (CBOs). They play a pivotal implementation and monitoring of program activities vis-à-vis • Fórum Mulher is strong in advocacy for gender equality the beginning, the consortium had to invest time in building
role in translating the overall objectives of your program into the donor(s). Financial and narrative reporting is therefore the and women’s rights, and has a substantial network of local trust, and agreeing upon roles and responsibilities. Now, the
real goals that are meaningful within the given communities’ responsibility of the lead organization. In most cases, they will member organizations, consortium sees many advantages in working together in terms
daily realities. be the one that is reporting to the donor. The lead organization • Pathfinder International has expertise in working with the of division of labor, a more diversified access to communities
• Peer educator representatives. They work on community should be able to coordinate and communicate with a variety public sector and in the capacity building of technical health and government and an increasingly efficient impact in the
level and have face-to-face contact with the (potential) users of partners and stakeholders, from the supervisory body, to care staff and community outreach, different components of the program.
of the female condom. CBOs and peer educators. It should have a good network and
expertise in financial and program management specifically. In
terms of structure, the lead organization may appoint a program
coordinator to oversee full implementation of the program, in
addition to local teams that are responsible for implementation
in different areas. Depending on their locations, either regional
program officers or a central level program coordinator 2.2 Community-Based Organizations (CBOs)26
will maintain contact with the CBOs and peer educators on CBOs play an important operational role in running your Pastor Chibuike Amaechi, state co-coordinator and member
community level. program within the communities. The involvement of these of the steering committee female condom in Lagos, director
types of organizations is invaluable as they have the local of health NGO the Good Neighbor.
The lead organization should make sure to formally engage knowledge, networks, as well as language proficiency that is Mushin, Lagos, Nigeria, 29 October 2009
CBOs and peer educators by clearly defining their roles, needed to make your program successful. In this regard, it is “Our concern here is with the women dying in labor.
responsibilities, and by making them aware of how they may highly recommended to have the lead organization actively That happens too often. So we asked ourselves: How can
voice their opinions on the overall program management. engage its CBO partners in the overall monitoring, evaluation we save the lives of young mothers? We use the female
This can be done by way of formally agreeing on a Terms and decision making regarding the program. For example: CBOs condom to achieve this. Women can use it themselves;
Demonstration of female condoms of References (ToR) or by signing a Memorandum of may be invited to monthly review meetings, staff retreats and they are in charge of their pregnancies.
Understanding (MoU). Monetary and material incentives need to meetings with the supervisory body. CBOs are the ones that can
Meaningful participation of all partners (lead organization, be agreed upon and formally documented by way of invitation recount success stories and, perhaps even more importantly, Many women have a child every year and 15 percent of
implementing partners and other relevant stakeholders) within letters and by keeping and confirming minutes of planning can document challenges encountered while implementing the mothers die in labor. Our healthcare system is so bad. I
the governance structure will encourage them to continuously meetings. Evidence of payments must be documented by way program on the ground and reaching out to (potential) female see in my neighborhood how things go; it’s frightening for
support and sustain your female condom program. Participatory of a receipt administration. Local NGOs/CBOs may be engaged condom users. It is most important to address these challenges everybody. So if you could prevent half the pregnancies,
program planning, on-going training opportunities, involvement by funding them and/or by offering them capacity building and successes in order to continuously keep improving your you’d save hundreds of lives. With the female condom
in review meetings, regular refresher training, and feedback sessions and by providing them with adequate products and program. Also, involving your local partners in retreats and women’s life expectancy would increase.”
on staff performance are all means to motivate CBOs and peer promotion materials. other meetings will strengthen their capacity and nurture their
educators to continue to be committed to your program. All engagement and commitment to make the program successful.
partners in the governance structure are required to have easy 2.3 Peer educators27
access to transparent and up-to-date monitoring information CBOs are involved in the sensitization of communities and Essential to your governance structure is inclusion of the
in order for them to be able to meaningfully participate in the Anonymous, Commercial Sex Worker significantly contribute to creating demand for the female individuals that have face-to-face contact with (potential)
program25. Buea, Cameroon, 5 November 2010 condom in their area of competence. They may be contracted female condom users. These peer educators share information
for the implementation of your female condom program within and educate users with regard to how to use the female condom.
You meet different types of men. Are there some who have the communities. This means that your CBO partners will incur They do this in face-to-face contact with (potential) users or in
rejected the female condom? additional administration costs that are to be covered. In the sensitization meetings with groups of people. They also offer
Did you know… “Yes. Many of them refuse. But if they refuse to use it I Memorandum of Understanding (MoU) signed with the lead the female condom for sale or distribute it free of charge. Peer
…That in Nigeria, some faith based organizations just leave. It makes me think that they are sick. I’m not organization, office running costs and administration fees need educators may include CBO staff, hairdressers and barbers,
educate people about the female condom? married. I am a sex worker and our lives are in danger. to be included. If CBOs are engaged on a voluntary basis, you and people that are part of the communities that you aim to
Because I meet many different men, and also certain may make sure to support them by offering to train them and by target. They are generally identified by the lead organization’s
types of men, I am in great risk and I know this. Reject it providing them with female condoms free of charge. technical staff. Often, different kinds of peer educators
and I reject you too. If they refuse, I go.”
26 See chapter 3: Community Approaches for the role of CBOs in female condom programming.
25 27 See chapter 3: Community Approaches for the role of peer educators in female condom programming.
Monitoring is described in chapter 1: Process
contribute to the female condom program at the same time. of an Advisory Board vis-à-vis the implementing organization
Either the (regional) lead organization or the CBOs involved are tend to be much clearer because of its restricted and clearly
supporting them in their daily activities in support of female delineated mandate.
Points of attention when installing your supervisory body:
• Members should be chosen strategically: they will represent
different constituencies and their commitment will create
increased support for the female condom in different
segments of society.
• Members should be involved from the very beginning of
the program so as to create mutual understanding of and
commitment towards the program’s objectives.
• Encouraging the relevant people to join your supervisory
body will need convincing advocacy efforts, repeated
attempts to get them on board, and some patience. Be sure to
adapt your expectations accordingly.
• Members should ideally include government officials, Promotionteam ETCHU Molyko in Cameroon
both in the policy and program field, (inter)national
Peer to peer education: Taxi driver explains the benefits and use of the NGOs, UN agencies, media, and donors. The more diverse
female condom to his colleagues your supervisory body, the greater the benefits for your
• Members may reach out to other government and civic
3. Installing a supervisory body leaders and seek additional (financial) support. Tips & Tricks
The operational team may be supported by a supervisory body • The entire supervisory body should meet every few months
that oversees implementation of your program. The supervisory with representatives of the operational team or lead • Establish a supervisory body (Steering Committee or empowerment, women’s rights, quality assurance, financial
body does not only advise on how to maximize the impact organization to make sure that communication is frequent Advisory Board), decide on its mandate, and involve the and program management, and advocacy.
of your implementation, it also has important added value and thorough. members from the beginning. • Engage CBOs and peer educators in the overall monitoring,
when it comes to advocacy. The members of your supervisory • The chair and deputy chair should have more frequent • Make sure there is adequate expertise within the operational evaluation and decision making of the program by inviting
board represent distinct groups within society and have strong contact with the lead organization. team with regard to communication, supply chain them to frequent review meetings and training sessions.
networks that they may put to use when advocating for the • Different supervisory bodies may exist at different regional management, social marketing, sexual and reproductive
female condom. Especially with regard to female condom levels. On national level, a supervisory body may be health, family planning, HIV/Aids, women’s
promotion, having such “champions” in your governance overseeing the entire country program whereas, on regional
structure is important for the execution and sustainability of the level, additional supervisory bodies may be installed to
project. oversee the activities in a specific areas.
• Statutes should be compiled and agreed upon that indicate
In terms of your supervisory body, you may choose to install the different positions within the body, the names of
either a Steering Committee or an Advisory Board. The the members and their membership duration, and the
distinction between the two is based on significant differences expectations of and the roles of each member.
in their respective mandates. • Members may be paid an allowance in return for the time
they invest in your program. The amount of the allowance Challenges
A steering committee may have both an advisory role and a allocated may be higher for the chair and the deputy chair as
decision making role. Equipping your steering committee with a they likely invest more time than other members do. Signing • A supervisory body will likely contribute significantly to manner will encourage most of them to show active
decision making mandate is a way to further involve and engage contracts with them is highly recommended. your program’s success, but may also take over control engagement. All different stakeholders need to be offered
them. It also offers recognition to its members as equal and regarding decision making and ownership. Make sure to be incentives for engagement that are meaningful to them.
important partners in your program, which will contribute to the clear about its mandate, role and responsibilities from the • Make sure to design a transparent and inclusive governance
overall sustainability of your program’s objectives. Nonetheless, very beginning and formalize this. structure in which each partner’s role and responsibilities
roles and responsibilities must be clearly defined and agreed Did you know... • The motivation and commitment demonstrated by the are clearly stated.
upon by the Steering Committee and the lead organization that ...That the Steering Committee of the UAFC project in stakeholders in your governance structure may vary.
is implementing the program. In this process, it is important to Cameroon is chaired by the Permanent Secretary of the Involving all stakeholders in a pro-active and transparent
make sure that enough room is left for the lead organization to National Control AIDS Committee?
make its own decisions and to define its strategies.
An advisory board solely advises the implementing and
operational team. In this regard, the roles and responsibilities
Chapter 3. Community approaches
Successful promotion of female condom use starts at A number of people or organizations are able to reach out to your target audience and making your program accepted in
micro-level. Individual mindsets and attitudes need Odilia Bessem Kum, Married, Mother of three children a given community and further your cause of female condom a community. For example, women’s groups tend to be in a
to be addressed and changed in order to encourage Owner of Beauty Salon promotion: position to reach victims of gender-based violence as well as
actual experimentation with the product. This requires Buea, Cameroon, 4 November 2010 • Civil society implementing partners, such as community- other vulnerable women. Men’s groups can help in promoting
sensitization of the most subtle kind, which often means based organizations, faith-based organizations, female the product to fellow men. Faith-based organizations tend to
that face-to-face and repeated interaction is needed How do you promote the female condom? condom peer promoters, women, men, and youth group have a large followership and strong influence on and links with
to actually reach potential users in a meaningful way. “I’ve worked with ACMS for about thirteen months. leaders; their communities. Involving these groups in female condom
Collaboration with people within the communities who are Initially, it was not very easy speaking in public and • Private sector partners, such as hairdressers and programming may contribute to the integration of the female
in a position to invest in education, counseling and sales demonstrating the artificial vagina. People would just barbers, pharmacies and drug stores, sex worker networks, condom into their existing sexual and reproductive health and
of the female condom is needed. People from within the start laughing. When I first started introducing this manicurists, private clinics, organizations employing men HIV/Aids programs.
community speak the appropriate languages, are more device to women, many of them said they didn’t like it. and women, and other female-oriented sales points. Hotel
accepted, and have networks which can all help to reach Others said it was clumsy, while some said it was too big. managers may also be considered;
people within communities. The appropriate persons may But when I demonstrated how it was used, some of them • Public sector partners, such as health and family planning
be identified by implementing partners at community started opening up. Some would come to me privately clinics, health workers, community health workers, HIV Did you know...
level. They may help in selecting, training and supporting and ask me to teach them how to use it. clinics, support groups for people living with HIV/Aids, ante- ...That a female condom has the same length as a male
appointed lead trainers and peer educators. This chapter natal, PMTCT and post-natal clinics, testing and counseling condom? People often think the female condom is much
provides tools for community approaches and describes I try to use different methods to reach people. Talking to sites. bigger, but this is not the case.
the engagement with private sector partners (such as women at social gatherings works well because there I
hairdressers) and public sector partners (such as health meet a lot of different people. Some rich and influential
clinics) and how their capacities may be built to educate women also buy from me. They don’t want to buy them in
and demonstrate female condom use. the open so they come to my salon, and while doing their
hair, they buy their female condoms. I have even been The lead organization28 may select civil society partners to
nick-named “Mammi Protectif’’. This has made me so collaborate with, based on certain criteria:
1. Introduction: Female condom promotion requires popular.” • Previous experience collaborating with the civil society
subtlety and sensitivity implementing partner;
Female condom programming is not finished when you have And your husband is ok with the female condom too? • The status and credibility they enjoy within a given
supplied outlets, public health clinics and Community Based “He really loves it, because it has solved certain issues community;
Organizations (CBOs) with female condoms and displaying like my fear to make love during my unsafe period. At • Familiarity with selected geographic locations in terms of
posters. That is just the beginning. The most important part times, when my husband complains of not having a language and culture;
of our work is related to people’s mindsets regarding female condom, I quickly offer him a female one. By using the • Sufficient supporting conditions like office space and
condom use. Many people are not aware of the existence of the female condom, we’ve been more happy in our home. In number of staff that are in a position to devote time to your
female condom as an alternative way of exercising sexual and fact many women come to thank me for bringing joy into project;
reproductive rights. Those who do know of the female condom their homes by introducing the female condom to them.” • Experience with community mobilization;
will not always have a positive view of it. A lot of work needs to • Experience with programming in general.
be done here.
2. Working from within is the way to go What official documents are needed to encourage proper
How can we make sure we have access to (potential) users of the In reaching out to people at community level, it is recommended collaboration?
female condom? The essence of female condom programming to work from within. People who know the communities and • Memorandum of Understanding (MoU) clearly describing
lies in working in the communities. The acceptance and the use speak the local languages will be more easily accepted and roles and responsibilities of the collaborating organizations;
of the female condom requires much education and counseling, trusted by the community. They will also be able to create • Documentation of agreements throughout the project phase;
preferably in inter-personal communication. On community safe environments for (potential) users who have questions • Evidence of financial transactions;
level, you will encounter hesitance, ignorance and taboos regarding the female condom. You need people on the ground • If an MoU is too formal for the relationship at hand, you
relating to sex, sexuality and the female condom as a female who are available within the communities to address the may revert to a more informal “partnership document”
controlled contraceptive method. This particular context asks questions and concerns of women, men, community leaders that indicates roles, responsibilities and the extent of
for collaboration with people and organizations at community and gatekeepers. These people will also have various networks commitment where the scope of work and funding does not
level that are in a position to adequately address these within the community that may contribute to creating an Aunty Queen Beauty Salon in Buea, Cameroon, demonstrations on the require bank transactions.
challenges. An important part of what we do is working hard to environment in which female condom use is increasingly use of the female condom are given
get these people on board! accepted and, hence, will eventually encourage female condom The civil society implementing partners are often best
use. equipped to identify intervention sites and select community
2.1 Civil society implementing partners educators who may serve in the capacity of lead trainers and
Collaboration with groups that represent or reach out to specific peer educators. They can also be made responsible for the
groups of people like Community-Based Organizations (CBOs) training of the lead trainers. It is important to have a lead trainer
Did you know... or faith-based organizations may be strategic in reaching among the implementing partner’s staff members for first-hand
... That peer educators carry out educational
talks in pairs?
28 See chapter 2: How to govern your female condom program
experience on programming issues. Civil society implementing to creating a supportive environment for female condom 2.1.B Peer educators
partners do not only implement communication activities, but programming and the creation of demand. They may belong to Education about the female condom requires a safe Habeetat Thaniolode, volunteer of the Society for Family
also carry out community-based distribution. All implementing organizations that have a wide reach in the communities by way environment and a delicate approach when communicating Health
partners also receive a stock of female condoms that they can of reproductive health, family planning and HIV interventions with (potential) users. The target group needs to feel safe and Educator at the neighborhood health centre
make a profit from when selling them. that they are a part of. They can also be influential individuals in comfortable so that they will feel free to raise their questions Lagos, Nigeria, 29 October 2009
a local community who support the project. Lead trainers need and concerns about female condom use. It often helps when
The lead organization is responsible for the creation of the thorough Training of Trainers (ToT) on IEC relating to the female peer educators are known in the community so that they are “I found out about the female condom through my work
preconditions that are needed to implement the program: condom. not perceived as total strangers. Peer educators who play a role with midwives. They see the women who get pregnant
• Timely payment of transportation fees and daily allowances; in inter-personal communication (IPC)29 are vital in the female year after year. I made the midwife in the neighborhood
• Timely payment of staff salaries; Lead trainers are involved in: condom education and counseling. enthusiastic about the female condom. She is now
• Timely payment of administration fees; • Building the capacity of peer educators and private sector recommending it to her clients.
• Support of office running costs; partners like drug store owners and pharmacists; After selecting lead trainers and training them (see Capacity
• Distribution of IEC materials and female condoms; • Visiting and monitoring the distribution outlets at community Building below), a plan of action should be made to select I’ve also seen to it that the neighborhood women’s centre
• Training and capacity building sessions to civil society level; the peer educators. Selection criteria may be based on the has now programmed the female condom. When women
implementing staff. • Advocating and working with community leaders and other following: return home after a delivery we give them a maternity
gatekeepers; a. Being representative of a certain group in society; kit, to which we add a female condom. So they can talk to
• Product distribution; b. Having credibility and confidence they enjoy in the their husbands about it. And say: ‘When you now want to
2.1.A Lead trainers • Facilitating linkages and referrals to outlets and public health community; go to bed with me, I won’t have to turn you down because
Lead trainers are key to the success of our program: they clinics; c. Interest and willingness to participate in the program; I’m not available because of the delivery.’ In this way we
disseminate their knowledge and experience to peer educators • Contributing to the development of training and d. Nomination by communities/NGOs/CBOs/facilities and work prevent men from going to other women.
in the communities. Implementing partners can help out with communication materials and data management tools. places. This usually ensures the nomination of a positive role
identifying and recruiting them. Our lead trainers function as model or suitable person.
links between the lead organization and the peer educators and Each lead trainer can support and supervise five to ten peer e. Having knowledge of and experience in working at the 2.2 Private sector partners:
sales points. The lead trainers make an important contribution educators. intervention site e.g. local language and culture;
f. The geographical location of the peer educator and their 2.2.A Hairdressers
proximity to the intervention site; Hair salons are part of women’s day-to-day life. Women often
g. Gender: both male and female peer educators are needed; visit the hair salon once every couple of weeks and they choose
h. Literacy level: they have to be able to use tools designed for the salon based on their acquaintance with the hairdresser and
data collection. the quality. The environment is safe and the customer stays
in one spot for at least one hour, often even more. Hence, it is
The peer educators receive promotion materials that they may the perfect occasion to introduce the customer to the female
use to share information, educate and communicate about the condom.
female condom. These include posters, T-shirts, gadgets, and
Case Study Nigeria caps. Targets are set with regard to the number of people they The hairdresser can benefit from selling female condoms and
need to educate, which geographical areas they need to cover, educating her customers about the product. They can attract
the quantity of female condoms they should distribute (sales some additional profit and it may attract new customers to their
and samples), sales figures, and how they can support sustained salon.
A well thought-through program to select, train and support Before starting their work, the selected lead trainers use of the female condom. Peer educators may sell the female
lead trainers has contributed to the success of the female- participated in an intensive capacity-building program. This condoms themselves after sensitization meetings, but they
condom program run by the Society for Family Health (SFH) program offers the correct information and explains the use of can also refer people to specific selling points. Peer educators
in Nigeria. For SFH, the lead trainers are vital in reaching out the female condom. Other than that, it also provides skills on are trained to use the IPC flip chart guide, which is a pictorial Did you know...
to communities. The selected lead trainers train and support how to select, train and support peer educators, and how to portable communication tool bearing female condom messages ...That peer educators are not paid but only receive
the peer educators. They are mentors for the peer educators, advocate to gatekeepers. SFH organized a series of advocacy based on specific behavioral determinants. travelling expenses?
and are the contact points for communities in explaining the visits to gate keepers with the lead trainers in order to gain
importance of the female condom program. The lead trainers support for the program and the product and to build the Peer educators work on a voluntary basis. That is why it is
bring SFH closer to the communities. capacity of lead trainers as advocates. important to offer them incentives, such as allowances for
transportation costs and meals. Another way of encouraging For the success of our program implementation, working with
In selecting the lead trainers, SFH talked to various community- SFH meaningfully involves the lead trainers and uses their the peer educators is to sell the female condoms to them at hairdressers is an advantage as users can be more easily
based groups such as civil society organizations, women, experiences and knowledge in the monitoring and evaluation a price that will enable them to resell for a small profit. Peer tracked. When returning to the salon after her first try, the
men and youth groups, and those involved in HIV work-place of the program. They are invited to review meetings and staff educators need the continuous support of lead trainers and customer can tell the hairdresser about her experiences to
policies and health facilities staff. SFH does not just recruit retreats, and are given opportunities to address programming the lead organization in terms of training, review meetings and which the hairdresser can respond by offering additional
anyone as a lead trainer; the trainers are selected according gaps and emerging issues. This ensures not only that there is a meaningful involvement in the monitoring and evaluation of the information or encouragement. The hairdresser should report
to criteria such as interest, motivation and willingness to feedback system to the program but also that the lead trainers program. on the number of regular users in monthly reports to the lead
participate in the program. Recommendations from government feel they can contribute and are committed in this way to the
bodies and networks as well as their track record in the related program.
fields or target groups are also taken into account. 29 For a more in-depth description of Inter-Personal Communication (IPC), please refer to chapter 4: How to communicate with potential users.
organization. In terms of our program evaluation, these reports to communities, directly with peer educators, or both. Civil
of sustained use are interesting and valuable as they will expose society implementing partners, that are often community-based
how we are doing, what strategies work well and which do not Did you know... organizations, have close connections with communities and its
in a given context, etc. ...That for married women the most acceptable way to gatekeepers and, therefore, have easy access to target groups
introduce the female condom is to introduce it as a FP to create acceptability of the product. However, the lead agency
Some of the benefits of working with hair saloons: method? may also decide to work with regional staff that works directly
• Hairdressers are commercially minded and good at selling with the peer educators and other stakeholders (private/
the product; public). The following case illustrates this.
• They are known and trusted among the women who visit the
salon; 3. Capacity building
• It is easier to follow up on the user; The selected stakeholders involved in the project, such as
• Hairdressers are visited on a regular basis and each hair civil society implementing partners, lead trainers, and peer Habeetat Thaniolode, volunteer of the Society for Family
dressing session takes enough time to adequately elaborate educators, need constant support in building their capacity to Health
on the product. implement the project. Some of the areas in which stakeholders Educator at the neighborhood health centre
require support are: Lagos, Nigeria, 29 October 2009
• Providing accurate information about the product and its “Today I’ll be educating people about the female condom
Did you know... use; at many locations in the neighborhood. I visit churches,
...Just as is the case with the male condom, women • Countering myths about the product; hospitals and traditional bed assistants (traditional
and men are not always satisfied after using the • Being able to explain the advantages of using the female midwives). Today I’ll be in the church. I go to places
female condom for the first time. A peer educator condom and discuss the concerns; where there is a need for education.
needs to follow up to help address and overcome the • Demonstrating the insertion and removal of the female
challenges and to encourage practice. condom using pelvic models or hands; The women in the church are very interested. They listen.
• Using communication and promotion materials; The midwife sent them to this meeting. They are having
At the Noble Pharmacy in Bamenda, Cameroon: attendant selling female • Advocating and working with gatekeepers; more and more children, which is dangerous for their
condoms • Learning about selling techniques or referral techniques; health. I explain to them what they could do about that. I
• Integrating the female condom into other activities and tell them it protects them against diseases, against STDs,
The pharmacist and drug store owner need capacity building programs, e.g. incorporating female condom programming in and that it helps in family planning.
and training in demonstrating the use of the female condom as family planning counseling programs, or in HIV-prevention
Elvis Oviasuyi, pharmacist well as addressing frequently asked questions by customers. programs. Nigeria is a poor country. Life here is hard. Everything is
Benin City, Nigeria, 2 November 2009 The pharmacies and drug store owners are supplied with very difficult. People have no money. You shouldn’t have
“In February this year I was invited to a demonstration promotional materials like posters and leaflets to attract These issues can be covered by a training session that is more children than you can afford. What are you going to
of the female condom. I was amazed. I had never seen (potential) buyers. The peer educators at community level especially designed for the lead trainers, who then go on to do when they’re all at school? We have a song about that.
something like that. At first I was skeptical, thinking may then refer female condom users to the drug stores and train the peer educators and disseminate knowledge and skills Family planning, what it’s all about; it makes everybody
that it wouldn’t work. I was afraid that it wouldn’t fit pharmacies, where the female condoms are sold. to them. A Training of Trainers session, female demonstration better. Shall I sing it?
right, and that it would easily slide up a woman. They models as well as a manual are all tools to ensure that messages
convinced me that it does no harm and cannot disappear and skills are disseminated correctly. Things are getting better
up a woman’s vagina.” 2.3 Stakeholders in the public sector Things are getting better
If the program’s focus is on social marketing, your main The lead trainers and peer educators play an important role As we plan our family
interest will not be in building the capacity of the public sector. in reflecting on the materials and information provided. Daddy getting richer
2.2.B Other private sector partners However, even if the program is not focused on distributing Their feedback is essential in the development of the correct Mummy getting younger
Pharmacies, drug stores, supermarkets, roadside kiosks, through the public sector, you will still need the help of doctors, information and tools to promote the female condom. Their Children getting healthier”
hotels and other private sector partners may be engaged in nurses, midwives and other public health staff. Hence, you experiences are valuable throughout the implementation of the
selling the female condom. They represent the places which may need to support them. For example: in many societies, the project. Regular meetings with lead trainers and peer educators
(potential) users frequently visit. Staff at these outlets needs doctor and the nurse are well respected, so if they promote the keeps them motivated, and also helps to review their work in
training, promotional materials and a constant supply of female female condom, people may be more likely to try the product. IPC and female condom demonstrations. 30 Did you know...
condoms. These private sector partners play an important role ...That in Mozambique, Community Based
in providing consistent access to the female condom. They are Health providers may be hesitant to suggest the female condom Organizations are involved in sensitizing their
less involved in community mobilization and inter-personal to clients. This may be caused by several things: the supply of 4. Reaching out to the community: added value of communities regarding family planning and the female
communication as their primary duty is to sell products or the product may be inconsistent, they do not have the necessary implementing partners and peer educators condom? This provides a more efficient way of working
services for a profit. Therefore, they are of service mainly for information and tools to educate clients, or they are not Depending on the context in which you are implementing your and ensures that the information is passed on by
regular female condom users who are already familiar with the convinced of the added value of the female condom themselves. program, it should be decided whether the lead organization someone who is familiar with the community.
product and its use. You may address these obstacles by sensitizing and training works with civil society implementing partners to reach out
the health care providers, providing educational materials like
flyers and a manual, and incorporating public health channels
in the supply chain management. 30 How lead trainers and peer educators can be meaningfully engaged is explained in chapter 2: How to govern your female condom program.
Case Study Zimbabwe
In Zimbabwe a technical support group chaired by the Ministry Peer educators: hair dressers, support groups for People
coordinates and monitors condom programming in the country. Living with HIV and sex worker groups
Civil society implementing partners are part of the governance The peer educators connected to the hair dressing salons, Tips & Tricks 5. Invest in teambuilding, continuous capacity building
and implementation structure under the leadership of the support groups for People Living with HIV and sex worker linked to continuous provision of female condoms and
Ministry of Health and Child Welfare. A total market approach is groups promote correct and consistent use of the female 1. Involving and training local community-based of promotion material: To keep CBOs and peer educators
used whereby the Zimbabwe National Family Planning Council condom and also sell the condoms to their clients and peers. organizations: CBOs have specific knowledge from within interested and motivated, it is important to invest time and
distributes the female condom for free, whilst PSI Zimbabwe The peer educators are from different salons and groups and their communities, contexts and networks. It is important to funding in the activities mentioned above.
socially markets the product. This implies selling the female the courses serve as a platform to share ideas on condom build interest, motivate, and acknowledge them. 6. Develop clear capacity building tools: It is helpful to
condom for a subsidized price. The private sector sells other promotion with their peers and clients. The peer educators are 2. Working with networks at community level: Community- convey accurate and consistent messages and address key
brands to those customers who can afford it. certificated and equipped with branded T-shirts and posters. based organizations know the communities and speak the issues in promoting the female condom in communities.
local languages, they know the issues and are generally A Training-of-Trainers manual will help to counter the
PSI Zimbabwe staff engage in interpersonal communication Private sector: road shows accepted. Community structures already exist and are easy challenge of high staff turn-overs in CBOs and among peer
themselves collaborating with civil society organizations, faith- PSI Zimbabwe also engages a private sector company which to use for different issues. educators. Customized IPC cards can sustain motivation
based organizations, and sexually active youth. Furthermore, conducts road shows nationwide. Together with locally-based 3. Identify, train, motivate and involve peer educators: because they standardize messages and reduce time spent
in reaching out to the communities, PSI Zimbabwe directly CBOs they conduct one to one and small group discussions. Peer educators are always part of the community, which on a session.
employs regional officers. These officers sell condoms, The company is contracted to reach a target number of people. makes them accepted by the community. Think about 7. Availability of female condoms and promotion
participate in interpersonal communication and supervise care They are expected to do a minimum of six shows per week. To incentives for them in terms of profit, personal development materials: When reaching out to the communities, it is
promoters, peer educators and private-sector partners. increase reach and coverage of the female condom, messages and allowances. Peer educators should keep track of important to ensure that there are sufficient samples,
are integrated with other messages such as those relating to sustained use. female condoms for sale, and promotion materials. All
Care promoters male circumcision and concurrent sexual partnerships. 4. Link up with mass media campaigns: These can support should be available to avoid disappointment of the target
Care promoters receive a training of trainers by PSI Zimbabwe the work of the CBOs. After mass education the CBO may group. Lead trainers, CBOs and peer educators need to be
staff. Care promoters sell condoms in the communities. They Distribution follow up with Inter-Personal Communications sessions. well equipped at all times.
then recruit and conduct training of hairdressers, sex worker More than 50% of the care female condom is distributed through 8. Plan for short interactive training sessions focusing on
queens and People Living with HIV support groups as peer the hair salons. The remaining 50% is distributed through the condom use skill acquisition and selling skills.
educators. In these trainings the peer educators gain skills sex worker groups, the PLHIV groups, pharmacies and private
in interpersonal communication and how to demonstrate health institutions. Monitoring is done through allocated sales
the correct use and discuss the benefits of using the female targets, sales documentation, quarterly stock takes and peer
condom. Care promoters regularly follow up on-job training education monitoring tools.
of peer educators. The care promoters are paid a monthly
allowance and transportation costs.
Did you know... Challenges
...That fortnightly mass awareness campaigns are
organized with peer educators of CBOs to sensitize Promotion and sales
people on the subject of the female condom and CBOs are generally good at selling ideas and the creation of
to set up sales outlets within the framework of an demand. However, they may face serious difficulties when
activity known as “tir groupe”? having to sell an actual product as most CBOs are used to giving
Fongeh Peters are married I talk about birth control, or that you can out products for free. Addressing the advantages of social
Team Leader, Etchu Peer Educators Team Buea use it when your wife is having her period. I give them a marketing, and creating incentives like profit sharing may
Buea, Cameroon, 3 November 2010 demonstration. I show them how to use it. I give them the Did you know... counter these difficulties.
price and I direct them to the shops where they can buy That post-menopausal women experiencing poor
Why did you choose to promote the female condom? it.” vaginal lubrication continue to have healthy sexual Geographical locations
“Because of the gender balance it brings. We already had lives when using the female condom? Selecting, training and supporting lead trainers and peer
a male condom, now we also have a female condom. It You talk to individuals and to groups — what method works educators in different regions may be a challenge in terms
gives women a choice. You can choose which one to use. best? of travel and costs. This may be countered by taking this into
Since men are dominant in this society I want women to “Actually both methods work. We try to find people that account when budgeting, as well as selecting lead trainers from
have something that is their own.” are leaders of associations, different organizations, various areas who will not have to travel while working with
communities or women groups. They invite us to visit peer educators in their area.
What kind of people are interested? them. The best is mixed groups, men and women together.
“We talk about the female condom to men, women, Then they see the advantages together. If you talk to
parents, all different types of people. I tell them about women only they still have to bring the female condom
the advantages of the female condom. For example, that home and convince their husbands or partners. Given our
it brings dual protection against STI’s including HIV/ social and religious background this can be a barrier.”
AIDS as well as unwanted pregnancies. For those who
Chapter 4. How to communicate with potential users
We want as many women and men to try the female condom risk groups, and ethnicity (for language and cultural purposes) 3.1 Rebranding: Is it worthwhile?
for themselves. Your communication strategies are essential Kehinde Mabel Ogunleye, master trainer of SFH are to be considered. For each target audience, a specific Prior to deciding on rebranding your female condom, you need
in achieving this goal. Many factors contribute to increasing Benin City, Nigeria, 2 November 2009 promotional strategy should be developed. to make sure that rebranding is absolutely necessary in order
interest for the female condom, but the most essential one “I provide education on the female condom and train to promote it successfully. Rebranding involves great cost,
is accurate and persuasive communication toward potential educators. I know that it’s difficult to convince people. time and energy and should therefore only be considered if
users. The media may play a pivotal role in this and is in a They say: ‘What is this, what’s in it for me?’ I then say: you have significant reasons to believe that rebranding will
position to make your work a lot easier, if collaboration is ‘It is not poison; just try it.’ But what you don’t know Did you know... fundamentally impact your programming. The added value
established in the right way. This chapter focuses on how and have never seen before, you don’t try so easily. ...That one of the hurdles for the promotion of of rebranding your female condom should be thoroughly
to select your target audience(s) and the messages that But I continue. Not only for the adults, but also for the the female condom is that women are often not investigated by way of market research. You may contract
you communicate to them. Rebranding the female condom children. They must know how to protect themselves familiar with their own anatomy and thus do not a market research agency to conduct a survey for you that
may prove to be an effective method to attract potential from diseases. feel comfortable inserting the female condom? will determine the image that the product should portray to
users. The different target audiences may be reached by Messages need to be geared towards overcoming the public. This needs to be pre-tested among your target
using a range of different communication strategies, such as Of course, not everybody is happy with the female this unfamiliarity. audience(s) prior to selecting a brand name and image to make
sensitization meetings, inter-personal communication by a condom. Men say: ‘I don’t want that; it’s not real.’ I teach sure that it does actually resonate. Alternatively, it may be the
peer educator, road shows, and handing out leaflets. our educators to ask them: ‘How are you going to provide case that there is an existing brand in your country already
for your children? How are you going to pay their school?’ which can also be applied to the female condoms that you are
We build awareness with men and women. I recently 3. Branding and rebranding the female condom introducing to the market.
1. Introduction : a carefully developed communication talked with a group of older women. For them it isn’t Branding is a powerful tool that will help people to relate to
strategy is the key about family planning. So I tell them: ‘Take home this a product and to believe in its use. Effective branding greatly
Your target audience(s) should be made aware of the existence story, preach this gospel to your children. Make them influences people’s perception of and interest in the product,
of the female condom as a contraceptive method, the benefits aware’.” meaning that it is supported by an attractive name, package and
it may have for them, and how to use it. All of this requires campaign. Branding is a way to encourage people to talk about a
thorough communication strategies. Your communication (branded) product. When being told about the female condom,
towards the (potential) user is supported by accurate and 2. How to determine your target audience(s) people tend to be naturally curious about it. The female condom
consistent messages as well as promotional tools and materials. The female condom is a tool that can benefit anyone that is will be more appealing to them when it has been packaged
Your communication strategies31 should be described in your sexually active. It is important to note that both men and women attractively. However, it is not merely the packaging that will
communication plan32. This plan is based on research on your need to be targeted and reached with female condom messages, determine a person’s perception of and interest in the female
target audience(s), what kinds of messages will resonate with and both need to gain access to the product. However, when condom: the overall branding of the product needs to be
them, and what tools will result in the greatest impact. This is designing your program, it makes sense to target certain groups appealing. This may include a branding campaign that makes
highly context-specific: one generic formula for success does of people specifically: if you try to reach all at once, you run the use of bill boards, radio shows and posters in order to spread
not exist. Nonetheless, some factors for success may in fact risk of putting out a message is so that general that it reaches the message on the benefits of female condom use. Street
be generalized: your messages should be accurate, concise, no one. All of your intervention strategies therefore should be marketing may be another useful option to promote your brand
consistent, and adapted to the specific target audience at all focusing on a specific target group. This will maximize your and get exposure. 34
times. Your messages should be supported by attractive tools. impact. Instead of attempting to reach out to everyone at once,
A brand makes the product more appealing and desired, hence, individual people tend to feel more directly addressed. When manufactured in their respective factories, each female
a brand campaign increases the success of your promotional condom type is produced according to a generic brand. In
sessions and sales. And last but not least, media plays an The selection of your target group depends heavily on the some countries, this generic brand is used to successfully
essential role in generating positive attitudes with regard outcome of your situational analysis, which relates to the raise awareness of female condom use. In other countries,
to female condom use. That’s why it is important to develop situation regarding sexual and reproductive health, HIV/ rebranding the female condom may be needed for it to connect
your communication strategies in collaboration with as many Aids and STIs in a given context or country. Whichever target to the specific target audience(s) so as to ensure that it will
stakeholders and potential users as possible as it will allow you audience you choose, your choice needs to be based on receive sufficient attention.
to fine-tune your communication about the female condom and evidence-based research. At the same time, it is important to be
maximize its effectiveness. aware of possible stigmatization of your target group for being Two types of rebranding scenarios may be applicable. In the
known to use the female condom. 33 first one, you procure the pre-branded female condoms from
the manufacturer and, upon arrival in your country, you add
Promotional strategies come in different shapes and an additional rebranded package to make the product more
forms: different target audiences are attracted by different attractive in the specific context in which you are working. In
Did you know... communication channels and messages. It is therefore the second scenario, you design a rebranding for your female Poster for the Care Campaign, promoting female condoms in Zimbabwe
... That the female condom offers a choice for HIV recommended to map your different target audiences based on condom and negotiate with the manufacturer such that your
discordant couples? their specific needs, which may be related to family planning female condoms are packaged according to your rebrand at the
and/or STI or HIV/Aids prevention. Not only gender aspects are manufacturing site. This means your very own unique branded
to be taken into account, also age, geographical location, high- female condoms will arrive as such in your country straight from
31 Refer to Bibliography and Further Reading for more information about communication strategies.
32 Your communication plan may be part of your marketing plan. Alternatively, it may also be a separate plan in itself. Please see Annex 3 for a simple example of a communication plan outline. 34 Street marketing may involve brand promoters working on the streets to promote the brand. They should be trained regarding passing short messages concerning benefits, negotiation of its use and correct
33 In some female condom programs in the past, women using or carrying a female condom were labelled “prostitutes” and were increasingly negatively perceived. use, after which they distribute free samples. They may work via an incentives scheme, or receive a monthly stipend, and should wear clearly identifiable outfits to increase visibility.
3.2 Branding campaigns messages to each of your target audiences at all times. In a 4.1 Examples of messages37 men feel more free during sexual intercourse, as it is not tight
Communication and branding campaigns should run in parallel multilingual country, the use of different languages needs to The information below is based on the FC2, which is the around their penis like the male condom is. Another advantage
to encourage curiosity and spark people’s willingness to be decided on. Each message should clearly communicate the most common female condom at the moment. Other types is in the fact that the FC2 may be inserted into the vagina
learn more about the female condom and to eventually buy benefits of using the female condom as a dual protection tool, of female condoms require different messages and overall before intercourse, meaning that the sex will not have to be
it. Media and communication campaigns should be launched with additional emphasis on its use as a family planning tool. 36 communication strategies based on their unique characteristics. interrupted. As the FC2 also conducts heat, having sex feels
no earlier than the moment at which your peer educators More detailed information, both on the FC2 and other female more natural. 38
and brand promoters are ready to get started and your sales To increase coverage and to widen the reach of female condom condoms, can be found in the Frequently Asked Questions
points are stocked and ready to educate and sell. Community messages, your messages may be integrated into other (FAQ) session. How to insert the female condom: Before opening the
outreach activities compliment mass media campaigns and help sensitization programs e.g. programs on male condoms, medical package, you should check the expiry date. If the female
normalize the female condom, minimize stigmatization, and male circumcision, concurrent sexual partnerships, sexual and condom has not been expired, gently rub the package so that
generate partner support for the product. reproductive health, and family planning. the lubricant is spread equally. Then you may tear the package
carefully with clean hands. Remove the female condom from the
Branding campaigns also create visibility. The target audience package. Place the inner ring between your thumb and index
can be asked whether they have come across a bill board or a finger and squeeze it like the number ‘8’. Put the inner ring
poster of the female condom brand. It should also be noted, Be aware that, in many countries, the male condom has been inside the vagina. When inserted successfully, the inner ring is
however, that introducing a new product or brand effectively stigmatized due to the fact that is has often been positioned as kept in place against the uterus while the outer ring is covering
takes a significant amount of time. It can take up to a couple of an HIV/Aids prevention tool. Keep this in mind in all decision the labia. As is the case with other contraceptive methods,
years before the brand is actually widely known. Initially, TV making regarding female condom positioning. In many countries, insertion of the female condom needs practice. It is advised
commercials and/or radio commercials introducing the brand positioning the female condom as a family planning tool has to practice inserting it before the actual sexual intercourse
may help to generate brand awareness. 35 facilitated product acceptance and use. takes place. Do not be discouraged when you do not succeed in
inserting it the first time. With some practice, this will improve
Did you know... How to remove the female condom: After having sex, you may
...Many women express surprise at the size of the Gideon Taka, Station Manager, Radio Hot Cacoa easily remove the female condom from the vagina by pulling
condom on first seeing it but accept the product after Bamenda, Cameroon, 3 November 2010 it out carefully. Once outside the vagina, turn it so that the
being taught about basic female genital anatomy and “Young people love music. So in the course of playing sperm will not come out. Dispose of it where others, especially
how to use the female condom? a good song, the animator can give some hints about children, do not have access to it.
the female condom. Our animators also attend music Poster for the Protectiv campaign: female condom programming in
festivals where they show samples of the female condom Cameroon Sexual pleasure: Apart from offering you protection against
to young people. But we haven’t specifically invited unintended pregnancy, STIs and HIV/Aids infection, the female
someone to come and talk about the female condom on About the female condom: The female condom is the only condom also contributes to the sexual pleasure of both you
4. Messages the air. We just talk about it spontaneously.” women-controlled contraceptive method that is currently and your partner. When using the female condom, the couple is
Whoever communicates to women and men about the female available. It offers dual protection: (1) against unintended less concerned with the negative effects that sex may have and
condom--whether it is the nurse, doctor, pharmacist, journalist, Do you think the media has an important role to play in pregnancy, and (2) against HIV/Aids and other sexually may focus on the nice aspects of it. Some men say that the inner
hotel owner, CBO, barbers, hairdresser, or other type of peer promoting the female condom? transmitted infections. The main difference of the female ring is an extra stimulant for the glands. Some women enjoy the
educator--messages about the female condom should always be “The media is the most important medium for reaching condom as compared to the male condom is that the female outer ring as it may stimulate the clitoris.
accurate, comprehensive and consistent. Peer educators need to young people. We have specific programmes targeting condom is inserted into the woman’s body. Hence, it looks
be comfortable and able to talk about sex, sexuality, pregnancy, young people and they listen to them passionately. There different as it needs to fit the woman’s body in order to offer Women and men may raise many questions regarding female
the human body and its private parts, HIV/Aids and other is always live feedback when they call in from far and ultimate protection. The FC2 has an inner ring and an outer ring. condom use and how to negotiate it with their partners. Peer
sexually transmitted infections, safe sex negotiation, and sexual wide. You know, people are always interested in their The inner ring is inserted into the vagina and placed against the educators, public health staff and outlet personnel need to be
pleasure. Additionally, each peer educator should be capable sexuality. Having interactive programmes to promote the uterus. The outer ring stays outside the vagina. The condom’s prepared! In the annex you will find a list of Frequently Asked
of countering existing myths regarding the female condom. And female condom is more effective than just broadcasting material is soft and comfortable. It is just as safe as the male Questions (FAQs) and suggestions with regard to how you may
many exist! For example: people may think that using the female adverts. ACMS does a programme with us every Thursday condom and provides you with an additional contraceptive answer them.
condom is uncomfortable. People may also question the level between 7-8 p.m. called 1OO% Jeune Life, where we choice. It depends on the couple whether the female condom
of protection in comparison to other contraceptive methods. address certain issues like why and how to use the will become their preferred method.
A peer educator has the important task to answer to these and condom and who has to insert it; this really attracts the
other concerns that potential users may have with regard to the audience.” Benefits of the female condom: The female condom offers Did you know..
female condom so as to build their confidence in finding their women control with regard to using contraception and ...That mass awareness campaigns are organized for the
preferred contraceptive method. protecting themselves and their partners, as they are the ones personnel of ministries in order to reach those people
putting it in. Men also tend to like it, as they do not have to generally overlooked by peer educators?
Messages need to be standardized to some extent in order wear a male condom. Using the female condom tends to make
to make sure to express the same, consistent and accurate
37 The messages below are generic and merely serve as an example of what a peer educator may emphasize about the female condom in his/her conversations with potential users. Messages should always
35 Brand awareness is a marketing concept that measures consumers’ knowledge of a brand’s existence. be adapted to accommodate the target audience and the specific context as much as possible.
36 See Introduction for the rationale behind the focus on family planning. 38 See Introduction for more benefits of female condom use.
5. How to communicate about the female condom 5.2 Sensitization sessions 5.4 Drama performances 6. Promotional materials and tools
There are different ways in which you may communicate Inter-personal communication may be complemented by Drama performances allow the audience to watch the different Attractive promotional tools and materials will help your
about the female condom to its potential users i.e. through group sessions in which a peer educator39 addresses groups opportunities and challenges that the use of the female condom target audience to visualize and relate to the product. When
inter-personal communication, sensitization events, edu- of people, e.g. on the market, in hospitals, during workshops, may present to couples. Drama performances often show sensitizing about the female condom, it is important that you
tainment, and by using visuals. Different strategies may be used or in meetings. As is the case in inter-personal communication, dialogues between sexual partners, raising common questions demonstrate the product. People should be able to see and
separately but, more often, combinations of communication the peer educator explains the benefits of the female condom and concerns. After the drama performance, discussions may even feel the female condom, complemented by a step-by-
strategies tend to be the most successful. and demonstrates its insertion into and removal from the be held in smaller groups to accommodate cultural barriers as step demonstration of its insertion and removal. The use of a
vagina by using a demonstration model or his/her hands. Group much as possible and to facilitate shy people so that they can female condom demonstration model is encouraged but, in
sessions may be organized in separate groups that may consist ask questions, touch and feel the product freely. the absence of one, you may also demonstrate female condom
5.1 Inter-personal communication of same-sex participants or both sexes, all depending on the use by using your hands. Promotional sessions may be further
When educating about the female condom, you need to talk context. This strategy will help to spark people’s interest in the supported by flip charts, posters and flyers. You may support
openly about sex and sexuality. This is often a very sensitive product and proves to be an effective method of informing 5.5 Visuals: Leaflets, posters and banners your peer educators by offering them discussion guides and
endeavor, for both the educator and his or her audience. It larger groups of people at the same time. The disadvantage of Posters, banners, leaflets, websites and other written and FAQ cards.
is important that the audience / potential user feels safe, this approach lies in the fact that the environment often does visual material provides you with a way of communicating
respected, and taken seriously. A good way of ensuring this not allow for very personal questions or concerns to be voiced towards your target audience(s). Messages should be the same
is by inter-personal communication (IPC). IPC is a face-to-face by the participants. That is why the peer educator, who has as the ones conveyed through inter-personal communication, 6.1 Developing material40
method that takes place between the educator and the potential been trained in counseling, should always be available after the sensitization or edutainment, but need to always be concise as When developing promotional material and tools, the following
user in which there is inter-personal dialogue about the female session has ended in order to address personal issues. people often are not focused enough to read large texts. Visuals steps may be followed:
condom and room for the user to voice concerns and ask should be made as appealing as possible by using bright colors 1. Focus group discussion: What kind of promotional materials
questions. and photos. After the promotional session, people may take a resonate with the target group? This depends on their level
5.3 Edu-tainment: Road shows and drama performances leaflet home to show it to his or her partner. They may also visit of knowledge, literacy and language use.
There are many questions a person may not dare to ask Another method used to raise awareness about the female a website for more information. The personal touch to female 2. Budget analysis: What budget is available for the production
when other people are around. For example, women may condom is by organizing road shows and drama performances. condom promotion nonetheless is essential to make people feel of materials?
be concerned about inserting the female condom into the Road shows are part of a communication strategy that aims to comfortable enough to open up to the product and its use. 3. Reviewing existing promotional materials and tools: Existing
vagina. Or men or women may not know how to introduce the entertain as well as convey key messages on female condom materials and tools may be adapted to suit the context and
female condom to his/her partner. These sorts of concerns will use. It is efficient as it generally has a much wider reach: one environment.
probably not be raised openly when they can be overheard road show may reach up to 250 people. The audience may 4. Message and visual development: What should be included
by others. Therefore, he or she may feel more comfortable be engaged by playing their preferred popular music while in the texts? How long should the texts be? What kind of
when having a one-on-one discussion with a peer educator. they learn about the female condom at the same time. During drawings and photos are appropriate and useful to include?
Furthermore, the potential user may touch and feel the the show, participants are invited to participate in condom 5. Developing new materials: A graphic designer should be
female condom and even practice the insertion with help of demonstration competitions and compete to win prizes. Also, contracted to design the new materials.
a demonstration model or his/her hands. The peer educator they may be invited to answer questions regarding female 6. Pre-testing: A focus group discussion with the target
thus plays an important role in creating a safe space and must condom use. It is important to note that the shy types may audience will help to identify the usefulness of the tools and
be comfortable talking about sex and sexuality. Although inter- not benefit as much from road shows. To engage them, the materials. Furthermore, pre-tests need to determine whether
personal communication is very effective in conveying accurate group may be divided up into smaller groups of 25 people to the target group actually understands your messages, texts,
and comprehensive messages about female condom use and help people to feel more comfortable and allow everyone to photos and drawings. These pre-tests may be continuous
addressing personal concerns of the potential user, this method touch and feel the female condom as well as practice condom throughout the development process.
also requires much time and effort, and outreach remains demonstration. Role plays of condom use can also be part of 7. Finalizing the materials: After adaptation and the pre-testing
limited. the show. Proper planning of the road show is key so that the stage, the materials may be produced.
facilitators are aware of the different segments that the show 8. Distribution: The materials are distributed to the peer
entails e.g. introduction, dancing, role playing, competition, educators and other stakeholders and they are trained in
small group discussions. using them.
Did you know...
...That some women feel safer using the female The discussions that take place at the end of the show are What does a peer education take with her/him?
condom as they claim their partners tear the tips of most important for people to remember your female condom • Samples of female condoms for demonstrations
male condoms to infect or impregnate them? messages. When an implementing organization is ill equipped • Female condom demonstration model41
to organize a road show, drama and theater firms may be • Female condoms for sale
contracted to organize the shows for them. Shows may run • Female condom manual for her/his own referral
daily or once every few weeks. Organizing road shows requires • Flip chart with drawings/photos
proper planning and preparation to make sure that it is • Female condom uniform: a baseball cap, a t-shirt, jacket, etc.
announced timely and appropriately within a given community. • Flyers/leaflets to give out
Poster for the Elegance campaign, female condom programming in
39 Refer to Bibliography and Further Reading for more information on peer education. 40 Refer to Bibliography and Further Reading for tools for developing information and education material.
41 In case of absence of a demonstration model, the peer educator needs to be trained to demonstrate the female condom use with his or her hands.
7. Involving role models to convey your message selected for over time. Keeping this in mind, these models may Furthermore, the song can also be played outside Cameroon
Public figures, such as musicians and other local celebrities, have to be changed over time to adapt to a changing context. because internationally renowned and popular artists have
may have a very strong influence on their fans and supporters. Research should be done to determine who could be used been associated with the project. Besides, it does not need any
When they convey the positive message on the female condom, as a role model and what messages they could communicate. authorization to be played in radios or clubs and people can
larger groups of people may be reached. It is likely that they Another important question is related to how they are relaying obtain the song and play it over and over again. In this way the
will develop a positive attitude towards the product because these key messages, bearing in mind that messages must impact of the message increases.
their idol promotes it. Popular role models have their own conform to the key message of the female condom programming
agendas, hence involving them in the promotion of the female within the specific national or regional context. As well as this, two promotional and educational TV and radio
condom needs to benefit them as well. If you engage an artist, advertisements were broadcasted and a poster campaign was
they can compose a popular song about the female condom. carried out in the project areas. Flyers were distributed and
It will increase their popularity and it shows that they are articles were written for the print media.
committed to the well-being of their fans. Another advantage of Ede Meyiwa (Mimi), field officer for SFH Lagos,
a song is that it is a long-term strategy: the song can be played Nigeria, 29 October 2009 One of the most important contributions this communications
even months after its launch and people will keep hearing it “At first people are always sceptical. They ask what I Manu Dibango is a well-known jazz artist from Cameroon, and the campaign made is that, besides the fact that people repeat
once downloaded or bought. Other role models like writers, want from them, why I visit. I tell them that I’m concerned leading artist in a music-video clip to promote the female condom in chorus the campaign slogan “I have things under control”
cartoonists, athletes or TV icons may also serve as entry points about their staff; that it’s about caring for people. When whenever given the opportunity, it also popularized the female
to a larger and often younger public. I tell them that, people open up. They ask me to tell them The song was broadcast on a large scale in various media, since condom to the public and quickly developed brand awareness
more and even ask for condoms, to give to their staff.” messages from artists have significant influence on the targets. of ‘Protectiv’.
However it is pertinent to note that role models are only human These leaders within the community were taken for models.
and they may not hold onto the ideals that they were originally In the preliminary phase of the production of the song, Focus The communications campaign “I have things under control”
Group Discussions were organized to identify role models and was launched by the Minister of Public Health and the Minister
to learn how they felt about promoting the female condom. of Women Empowerment and Family. It aimed to encourage
After that the whole production process started, from signing appropriation of the female condom by the target groups
contracts with artists, managers and production agencies, to through awareness of its proper use, and involvement of men to
writing the song and video clip, to recording, mixing and editing. support their partners in adopting this method of contraception.
These combined actions will lead to the elimination of prejudice
Till today, the song and the video clip have remained in and stigma in relation to the female condom.
the playlists of radios and TV stations and can always be
programmed later on. Thus, the lifespan is not linked to the The song can be downloaded
Case Study Cameroon duration of the project. http://www.youtube.com/watch?v=65kYjCyTedA
Chapter Media An important part of the campaign included a popular (but at
the same time educational) song on knowledge and correct use
Case Study: Media Campaign “I have things under control” of the female condom. This promotional song was recorded
- Cameroon by national and international artists and distinguished leaders 8. Media for female condom promotion myths and misconceptions that surround the female condom.
including Manu Dibango, Anne Marie Nzié, Narcisse Pryze, People receive hundreds of messages per day through TV, 3. Rebranding. If you have decided to rebrand your female
Under the title “Je prends les choses en main” (“I have Lady Ponce, Isnébo, Prince Afoh Akom, Majoie Ayi, Nono Flavie, news papers, the Internet, radio and magazines. Media are an condom, branded mass media campaigns will support the
things under control”) ACMS developed a comprehensive Corry des Macases, Valséro, Atango de Manadjama, Kardinal effective way to send out messages about the female condom introduction of your unique brand in the market.
communications campaign to facilitate the acceptance of the 1er, Valery Ndongo, Michèle Ngoumou, Boudor and Fally Ipupa. and contribute to a positive attitude towards it. However, it is 4. Advocacy. Campaigns and media messages do not only try
female condom by the people in Cameroon. ACMS worked with Through this song, all these well-known and respected people not easy to explain what the female condom is, what its benefits to convince the end user to use female condoms, they also
the support of a Communications Consulting Agency. sent an important message to a large number of the people of are, and how to use it by using the type of short and catchy target decision makers at different levels. Decision makers
Cameroon. sentences that media often use. Therefore you should carefully get a sense of urgency and importance when they see and
The campaign showed that the female condom is a device used design and monitor the impact of your media messages. When hear about the female condom through different channels.
to prevent unplanned pregnancies and STIs including HIV, Messages developed during the campaign focused on planned and executed with care, media has certain advantages:
not only for all women who know what they want, but also for various issues, such as myths about comfort, esthetics and
men who want the best for women. The campaign had three reliability; ignorance about the female condom and its use; and 1. Recognition and acceptability. When using different
objectives: stigmatization of users of the female condom as being reserved media outlets to convey your message, people will recognize
1. The development of the brand name ‘Protectiv’, to sex workers. To solve this problem, communication themes your campaign after a while. Seeing and hearing the same Did you know...
2. Building the capacity of women to be able to use the female encompassing all the contours of the problems of the female message in the public arena will eventually normalize the ...That many peer educators respond to the complaint
condom correctly and to use it as a device for family condom were elaborated by ACMS. Interventions were relevant product and will contribute to increased acceptability. that the female condom is a little expensive by saying
planning, in the sense that they were presented in the form of advice and 2. Awareness raising about the female condom. Media can that having an unintended pregnancy or STI is much
3. Help men to encourage their partners to use the female prescriptions from those who are models for the target. be a strong tool to communicate a positive message about more expensive?
condom. the product, while at the same time countering the concerns,
8.1 Media planning channels. Easily recognizable jingles or music in TV and radio partnerships with private, public, federal and state media Visibility, consistency and repetition of the female condom
Media can be a powerful tool to sensitize people about the campaigns may also increase the popularity of the product. organizations may get you free air time dedicated to sexual and message in the media will contribute to getting the female
female condom, while at the same time its effects can be Jingles can additionally be formatted into ringtones. reproductive health, women’s rights and HIV prevention. These condom message to resonate with people. If, at the same time,
disastrous if expressions in the media contain incorrect and partnerships will significantly contribute to the success of the people see posters, leaflets, and other promotion materials
stigmatizing messages. Working with media therefore requires Before starting your broadcasting campaign, it is recommended female condom program. Knowing what interests them as media at shops, hairdressers or with peer educators, they are more
thorough planning. Before starting it makes sense to find out to look into the need to be granted permission from a regulating partner will help you to emphasize the mutual partnership. Key likely to adopt a positive attitude towards it. Complementarity
which media and advertising laws exist in your country. In body. Pending decisions by these bodies may delay the project. to successful partnerships is inclusion of representatives of the of communication channels and strategies is therefore very
some countries, a law is enforced that orders the prohibition If possible, it is wise to involve these regulating bodies in the union of journalists in the program’s supervisory body from the important.
of advertising for medical products. If this is the case in design of the media campaign to avoid unexpected negative start of the program.
your country, you need to find out if the female condom is responses and even prohibition of launching the campaign.
considered a medical product in your country, before designing
and planning your marketing strategy. If so, it is advisable to 9. Visibility Did you know...
involve the Ministry of Health to avoid prohibition of female There are specific moments throughout the year that offer ...That one of the biggest concerns of women is the fear
condom advertising. Women, Promoter of the Mey-Low-D Foundation opportunities to raise media attention to female condoms of the female condom slipping into the vagina42?
Bamenda, Cameroon, 3 November 2010 e.g. Women’s Day (8 March), World Contraceptive Day (26
“I tell people that what we are trying to promote here is September), World Aids Day (1 December), or visits of foreigners
responsible sex. We want people, irrespective of their or delegations to the country.
religious background, to feel free with their sexuality.
We want them to protect themselves and prevent the
spread of diseases. We make sure that we have no moral
judgement from those who see us as sex promoters. No
parent would be happy if their child contracted a disease
or carried an unwanted pregnancy; most parents will 10. Advantages and disadvantages of the use of different communication channels
be happy to know that their children are able to protect
Communication Channel Advantages Disadvantages
8.3 Monitoring Inter-Personal Communication • permits dialogue • requires specific training and follow-up
• creates a safe environment support
Expressions in the media need continuous monitoring.
• allows personal issues and concerns to • reach is limited
Hot Cocoa Radio Station Bamenda in Cameroon: Radio is an important Newspapers, radio or television may publish or express
be raised • difficult to keep messages consistent
communication channel negative or inaccurate statements regarding female condom • allows for a tailor-made response and • may be expensive
use. Fix mistakes by responding with letters or articles in education
newspapers or on the Internet. By having fact sheets ready, • allows for a clear message (no
responses can be quick to limit the negative impact of an distraction from environment)
Did you know... incorrect piece in the media. Proactive press releases should be
...That the Armed Forces are involved in the project sent out on a regular basis. Community level activities: • higher number of people reached at the • less opportunity for personal questions
through women soldiers and the wives of the military sensitization meetings, road same time and concerns
being trained and acting as peer educators? shows, drama, community • may have more credibility because of • low frequency
8.4 Capacity building of media and partnerships media support from community leaders • low reach as compared to mass media
In many countries, especially where female condoms are fairly • may allow for participatory approaches • may be costly, especially when wanting to
• may be more cost effective due to large scale up
unknown, messages in the media tend to stigmatize the product
number of people reached at one time
and at the same time contain incorrect information. One way to
8.2 Media channels give your communication a positive twist and limit the extent
Media: tv, radio, newspapers, • great outreach • target audience may not have access
There are different channels of communication that support to which negative messages about the female condom are
magazines and internet • many publications on public health to • needs continuous monitoring
your message. Conventional channels like (community) being expressed is to build the capacity of journalists in their tap into • relationship-building with media is time
radio, television and newspapers are worthwhile to explore. reporting on the female condom. It is important for expressions • reaches out to many different target consuming
However, there are more ways of integrating female condoms in the media to be as consistent and unambiguous as possible. groups • your message is not always newsworthy
into existing media, like having it mentioned in TV interviews, • can use local languages • it may be very costly, especially when
or having it discussed in discussion programs, soap series or At the same time, media directors can be offered training on • news articles have space for producing TV spots and buying air time
movies. It is recommended to get informed on what kind of the subject. This will help in negotiating media prices. It is elaboration and nuance
media the target group(s) use and in what languages they can recommended to be informed about the various media laws • the Internet reaches young people
be reached. This should be integrated in the initial research by that exist in the country to see if there is maneuvering room • allows for creativity
which you determine your communication strategy. Innovative for negotiating a reduced media price. In many countries it is
communication channels such as group SMS and social media very expensive to buy airtime and broadcast a female condom
(e.g. Facebook, Twitter, YouTube) can be useful to attract your media campaign. Investing in partnerships with media outlets
audience and may prove to be very strong communication can help you to overcome this difficulty. Additionally, building 42 This cannot happen due to the outer ring outside the vagina. See also FAQs.
Tips & Tricks
• Your communication strategies should be described and • Properly equip your peer educators with samples of the
justified in your communication plan43. This plan is based on female condom, a female condom demonstration model,
research on the target audience, what kind of messages will female condoms for them to sell, a female condom manual
likely reach them, what tools will have the greatest impact for her/his own referral, a flip chart with drawings/photos, a
and will bear the best results. female condom uniform, and flyers/leaflets to hand out.
• Selecting your target group(s) is informed by the situational • Find out if rebranding of the female condom is necessary. If
analysis you conducted in your country, emphasizing the so, contract a branding company and make sure to conduct
situation with regard to sexual and reproductive health, HIV/ regular pre-tests with your target audience.
Aids and STI infection rates. • Consider the timing of your communication, branding and
• Make sure that your peer educators are comfortable talking media campaigns. When they run in parallel, people are
about sex and preferably have used the female condom more likely to recognize your product.
themselves to be able to discuss their own experience. • Engage popular celebrities to contribute to a video clip,
• Invest in people and places where inter-personal radio or TV commercial, or any other expression in the
communication is able take place: a hair salon where the media that will give exposure to the female condom.
female client is educated about the female condom in • Conduct a study on media usage, reach and languages used.
private is a safer space than a crowded bus station. • Think of attractive messages that you may use to praise the
• At the same time: identify places where you will find large female condom in the media and use jingles or music that
groups of people (like markets and bus stations) for group people will recognize easily.
sensitization meetings. • Complement your mass media campaign by conducting
• Road shows may link serious messages with entertainment regional and local promotional activities.
and attract large groups of people. Make sure that there is • Build the capacity of journalists and media directors to
space for smaller group discussions afterwards to address increase your chances of having them express accurate,
questions and to make sure people understood your consistent and unambiguous messages about the female
messages. condom and expanding your exposure in the media.
• During promotional sessions you should use the support • Include representatives of the union of journalists in your
of visuals, such as posters and leaflets, and refer people to program’s supervisory body.
your website for more information.
• People using the female condom may be stigmatized in method only, e.g. it can come to be perceived to be ”cool” to
society. Hence: consider promoting the female condom as a carry a certain brand of condom with you. Carefully assess
contraceptive method for all sexually active people and do your specific context, your organizational capacities and
not only specifically target one or several high-risk groups. available funding when consider whether rebranding is
• After training your peer educators it may be the case that, feasible and necessary for more effective female condom
over time, messages become inconsistent and inaccurate promotion.
information is being shared. This is only human, as peer • Developing, publishing and repeating your female condom
educators may forget what they have been taught during media campaign may be very costly and time consuming.
their training and/or new developments may affect your Invest in the most effective channels of communication
preferred messages. Therefore, you should visit your peer available to you and budget for it accordingly.
educators while they are educating people and invite them • The lack of knowledge of journalists and media directors
for regular review meetings to refresh their knowledge. can result in negative messages about the female condom.
• Rebranding is a time consuming and expensive exercise that They need sensitization and guidance in publishing about
requires the involvement of many stakeholders, including the product and/or related fields.
the government. Nonetheless, rebranding may also have • Government bodies or other regulating mechanisms may
major advantages in making the product more appealing delay their approval which in turn delays the airing of mass
and distancing the user from the product as a contraceptive media campaigns. Beware of this and plan for it in advance!
43 A communication plan can be part of a marketing plan, but can also be a separated plan.
Promotion sticker of Protectiv female condoms at the Sidony Beauty
46 Salon in Bamenda, Cameroon 47
Chapter 5. Advocacy towards decision makers
The female condom is often a fairly new and unknown enough. Citizens or organizations can and should hold
contraceptive method in a given society. Moreover, when governments to account with regard to their rights to overall Elvis Oviasuyi, pharmacist
people do know about the female condom, it tends to be good health, sexual and reproductive health in particular, and Benin City, Nigeria, 2 November 2009
surrounded by stigma and taboos. Hence, the support of access to contraceptives including the female condom. “We use it because we think it’s fun, but it also comes in
decision makers is of great influence in the promotion and handy in family planning. We have three children, still
overall societal approval of the product. Generating an It is important to continuously bring female condoms under young; that’s plenty for us.”
overall positive attitude towards female condom use and the attention of decision makers in government or parliament,
its benefits needs constant sensitization and engagement because government faces many issues in society which will
of influential societal leaders. This chapter describes be competing for attention and funds. Personal and political
how you may advocate for your cause with different interests also determine the level of commitment. Decision 3. Developing an advocacy strategy
decision makers—such as community leaders and other makers need to constantly be reminded of the importance and Advocacy requires proper planning and a comprehensive
gatekeepers, government and institutions—so that you urgency of investing in female condom programming. They are strategy. The ten-step process described below will help you
will generate their support, effectively promote the female the ones that can turn the tide: they can exert their influence to to develop an appropriate advocacy strategy to encourage the
condom with them and, subsequently, secure funding bring about positive change. policy or decision making change you need to successfully
for female condom programming. This will significantly promote female condom use.
contribute to your ability to create demand and increase
access to the female condom. Demonstrating female condoms to the Minister of Women Empowerment
and Family in Cameroon.
1. Introduction: Exerting influence to bring about positive Advocacy is a time consuming and continuous exercise. Within
change your operational team, staff should have the competencies and
The success of the implementation of your female condom time to engage in advocacy processes. Successful advocacy The 10 steps of your advocacy process47 6. Select channels of communication
program depends to a large extent on how conducive and requires a very specific skill set and even a certain personality Common advocacy channels are position papers, letters,
supportive the political and social environment is in which type. It is important that your advocacy staff is able to build 1. Define the issue fact sheets, public debates, and conferences targeting policy
you work. Community leaders44 and other gatekeepers45 as and maintain sustainable relationships. They should be able to Advocacy begins with identifying the issue or problem that makers. Your target audience determines the most
well as the national government need to be actively engaged communicate a convincing message and empathize effectively requires a policy or decision making change. appropriate medium for your advocacy message.
with your female condom programming to avoid resistance to with the points of view of different stakeholders. If there is no
the product and to the people who implement your program. institutional capacity to hire an advocacy officer, it should be 2. Set goal and objectives 7 Raise funds
Government in particular should play a role in making clearly indicated who will take up these activities and dedicate A goal is a general statement of what you hope to achieve in Advocacy campaigns always benefit from external funding
female condom programming sustainable by developing and (part of) his or her time to it. the long term (three to five years). The advocacy objective and other resources. Identify possible donors for the
implementing supportive policies and by allocating necessary describes short-term, specific, measurable achievements campaign.
funding. Advocacy is a process of both engaging decision that contribute to the overall advocacy goal.
makers, as well as ensuring sustainability by integrating female 2. What is advocacy? 8. Develop your implementation plan
condoms in national policies and programs. When government Advocacy is a process aimed at decision makers or policy 3. Identify your target audience Develop an implementation plan that identifies activities
officials or other influential leaders or gatekeepers are part actors to bring about a change in policy, budgeting and/or The desired policy change is facilitated by specific decision and tasks, responsible persons/committees, the desired time
of the supervisory body46 of your program, this will positively legislation according to your cause. Female condom advocacy makers or other influential people. Assess their positions frame, and required resources.
influence your overall advocacy objectives as they can promote generally aims to encourage the development of supportive and relative powerbase and find out whether or not
your cause with their colleagues, constituencies, and in their government policy that ensures the availability of and access to they support, oppose, or are neutral to the issue you are
networks. However, getting them on board is an entire advocacy the female condom for anyone who wants to use it. An advocacy advocating for. Ongoing activities:
process in itself. process benefits larger groups of people. Advocacy works
towards policy change, which is always long-term. This is what 4. Build support Collect data
distinguishes advocacy from changing opinions and behavior. Find supporters to strengthen your advocacy message within Advocacy objectives, advocacy messages, and identifying the
Advocacy helps to create an environment in which female NGOs, networks, donors, coalitions, civic groups, journalists, policy and decision makers and your supporters require data
condom use is supported and able to spread. churches, professional associations, women’s groups, collection. This is an ongoing process.
Did you know... activists, and individuals.
...That famous artists and personalities are Monitor and evaluate
committed to promoting the female condom through 2.1 Why is advocacy important? 5. Develop your message Monitoring and evaluating the advocacy process is about
songs? In every society, there are issues that are not adequately Advocacy messages need to be adjusted according to the measuring your progress and results. What achievements are
addressed by government. Often, this holds in particular for target audience and include the problem statement, facts, you aiming for? When defining your advocacy objectives, make
sexual and reproductive health matters as openly discussing persuasion and the desired action of the policy and decision sure to consider how to measure them.
them is a taboo, considered complex and/or not important maker.
44 Community leaders are local government leaders and religious leaders.
45 Gatekeepers are opinion leaders like chiefs, traditional rulers, and other influential people. 47 Based on the 10 Steps in the Advocacy Process of the Policy Project: Networking for Policy Change: An Advocacy Training Manual by POLICY (January, 1999),
46 See chapter 2: How to govern your female condom program http://www.policyproject.com/pubs/AdvocacyManual.cfm
3.1. Defining the issue Specific: The objective has to be clear and say exactly what the need to be aware of existing policies, committees, strategies parliamentarians or parliamentarian groups, national HIV/Aids
When developing your advocacy strategy, you should outcome should be; and programs that involve the government and are influencing committees, national HIV/Aids technical bodies, or reproductive
determine a problem or an issue in your environment, region or the playing field for female condom promotion. Some countries health/family planning technical bodies or working groups.
country that you expect may be positively influenced by policy. Measurable: In order to know if you have achieved your have condom strategies already that could perfectly fit in
In the field of female condom promotion, the problem is likely objective, it is best to have quantitative goals, e.g. indicating by female condom promotion. Most countries have a national In order to target the policy makers who are in a position to
to be related to sexual and reproductive health and HIV/Aids. how much funding should be increased; reproductive health or HIV/Aids policy. This data collection contribute to positively influencing the position of the female
Examples of the advocacy issue could be: should be done as a baseline study: you will need to assess condom in your country, it is helpful to identify and analyze
Achievable: The objective has to be ambitious, but not overly and document the current situation so that, when you evaluate them on the basis of certain criteria.
• In country X, there are [number] unintended pregnancies due ambitious so that it is impossible to reach. It has to motivate the impact of your advocacy strategy, you will know if you
to a lack of access to contraceptives; people to do their best and know that they can achieve the have had any impact. It needs to be noted however that budget For example:
• In our country, women and men do not have access to stated goal; analysis is extremely difficult as many governments are not very 1. The status they enjoy nationally;
contraceptives; transparent in publishing these figures. 2. Their political influence;
• In our province, many girls are getting pregnant because they Realistic/Relevant: The objective has to aim towards achieving a 3. Objectives that they aim to achieve in their personal and/or
lack knowledge and access to contraceptives; real win, so that people working on this goal see the purpose of What is more, you should reflect on the skills, knowledge and professional lives that relate to the areas of intervention of
• Over the last 5 years, the number of people in our country working on it. resources that are available in your operational team and what your organization or the female condom programming;
contracting HIV/Aids has increased; you will need to be able to achieve your objectives and your 4. Their participation in programming focused on HIV/Aids
• Men and women in region X express a demand for the female Time bound: By stating a target deadline for the objective, and overall goal. At the same time, be aware that your environment control and/or sexual and reproductive health and family
condom, but it is not available; later on a time-line, there will be a sense of urgency and you will may change, e.g. elections may be held or policy priorities might planning;
• In our region, many people lack the skills to protect be in a position to track whether you are on schedule. change. Include this type of risk analysis in the documentation 5. Their past collaboration with the implementation
themselves against HIV infection. of your goal and objectives by trying to anticipate these organizations involved.
In addition to the use of the SMART-elements, you may add the changes.
Your advocacy issue should be supported by research data policy actor or decision maker that you will target to make the You should have a clear understanding of the decision making
which may include focusing on the user level and/or analyses objective even more specific. For instance: Setting the goal and objectives is strongly related to the third processes in your country50:
of public health reports by government, NGOs and research step, identifying the target audience. When you know whom to in some countries, all decisions are made in national ministries
institutions.48 • In one year’s time, female condom promoters have had one target, you may include that decision maker in your objectives. which give orders to their localized ministries. Alternatively,
or more contact moment(s) with relevant representatives in other countries, the decision making power lies with the
of the Ministry of Health to discuss commitment to female decentralized ministries or parliaments. In addition, you should
3.2 Set overall goal and objectives condom programming. anticipate decision making moments so that you can plan well
The problem that you have determined to be your advocacy • In two year’s time, the Ministry of Health in country X publicly Seyi Jamoh, hairdresser and HIV positive in advance in order to influence the outcome of the decision
issue needs a solution. Your advocacy is geared towards supports female condoms as a modern contraceptive choice. Lagos, Nigeria, 29 October 2009 making process. For instance:
positively influencing the problem. You will set a goal, which is • In four year’s time, the Ministry of Health has committed to “I also use them myself. I must protect myself. I have
always long-term and which addresses your advocacy issue. For including female condoms into the next multi-annual national four children, three boys and a girl. Protection remains In country X, the national Ministry of Health revises the national
instance, your goal might be: condom strategy. necessary, even though I already have HIV. My husband condom strategy every 5 years, starting the process two years
is also HIV positive, but he has a different form. We both before the current strategy ends.
• In 5 years’ time, the government of country X has integrated You can also select objectives that will support your advocacy take antiretroviral drugs, but we must not complicate
female condom programming in their national condom to decision makers, for instance by involving media or by matters further and infect each other. That would mean In this case, you know when to start your advocacy (at least
strategy and has allocated sufficient resources to sustain it. identifying influential “female condom champions” who have yet more medicines to swallow. I have no resistance to 2 years before the strategy ends). At the same time you need
access to decision makers: new infections. to know how the government facilitates this revision process:
Your long-term goal reminds you of where you are headed and is it open to civil society participation? Or is the new strategy
when you would be satisfied about the impact of your advocacy • In one year’s time, at least 10 media outlets (radio, TV, Besides I don’t want any more children. And I have more written without any consultations?
efforts. It is important to remember that your advocacy goal magazines, newspapers) have expressed themselves fun in sex with the female condom. It touches the lining
represents a policy change. It should include the action of positively with regard to the female condom. of the vagina and enhances the pleasure; it stimulates the Or:
decision makers, e.g. in this case, they have integrated female • In two year’s time, at least three champions have been vagina lining. Yes, it is more fun with one.” In region Y of country X, the local Ministry of Health drafts the
condom programming into one of their policies and provide identified and have committed to promoting the integration annual plan and budget for the public health facilities in that
sufficient financial resources to sustain it. of female condoms in the national condom strategy within region in October of each year.
government structures. 3.3 Identify Target Audience: advocacy towards the government
In order to achieve your overall goal, you need short-term Who are the people or institutions that have the power that In this case, you need to target the local Ministry of Health
objectives that will lead you there. When identifying your short- Needless to say, the identification of the advocacy goal and is required to bring about the desired policy change? This before and around October to have it include female condoms
term objectives, you should specify them according to SMART- objectives is very context-specific and needs to be supported question is important when identifying your target audience. in the plans and budget for the public health facilities.
criteria49: by research and data collection. If you ask for an increase of As advocacy is a process aimed at decision makers and
funding for female condom promotion, you need to know how policy actors, your target audience is always someone in the Knowing who is the ultimate decision maker and when decision
much funding is spent on female condom promotion today. You government or parliament, for example: Ministry of Health, are being prepared and taken will help you to identify your
Ministry of Finance or Planning, Ministry of Women and Gender, target and plan the timing of your advocacy efforts.
48 Refer to the chapter 1: Process for more information on data collection to inform the design of your female condom program. This data may also be applicable to your advocacy strategy.
49 50 Refer to IPPF (2009) for an example of how to do analyze decision making processes and to assess where you can have influence: IPPF (2009), Generating Political Change, using advocacy to create political
For more information on defining SMART advocacy objectives, please refer to: Networking for Policy Change: An Advocacy Training Manual by POLICY (January, 1999), page III-28.
http://www.policyproject.com/pubs/AdvocacyManual.cfm. commitment, page 35.
3.4 Build support 3.5 Develop your message Example of a one-minute message about the female condom: Therefore, media publications may strengthen your advocacy
Advocacy is not a process that should be executed in isolation. Your advocacy message should be adapted to every specific efforts by raising public awareness about the importance of the
Finding supporters strengthens the advocacy message and target audience. Messages should ideally link to wider policy or “Female condom programming is important for the health issue and by holding government accountable.
increases the credibility of the organizations that are advocating public debates. You may do this by taking a specific angle that and well-being of our population and urgently needed. In our
for your cause. Supporters can be found in women’s groups, will allow you to connect the female condom to a wider debate country, one out of every twenty people is infected with HIV/ Another way to involve influential people is to have them take
youth groups, men’s groups, among parliamentarians, health e.g. by demonstrating how the female condom is complementary Aids. Each day, 100 unintended pregnancies occur. The female part in the official launch of your female condom program.
practitioners, community leaders, gatekeepers and the to the male condom, by discussing the involvement of men as condom protects against HIV/Aids as well as unintended Ministry officials, parliamentarians, or members of national
program’s peer educators. Choosing the right people with the partners and role models, by addressing the empowerment of pregnancy. The provision of female condoms would thus help technical or implementing bodies could also be invited to
appropriate networks and contacts will contribute to reaching women to negotiate and use the condom, by emphasizing the to keep our population healthy, but is not yet widely available. become members of your program’s steering committee or
out to policy makers and other influential leaders. Members importance of the integration of the female condom into existing Zawadi, a woman who visits our clinic, recently found out that advisory board. 53
of the advisory board or the steering committee may fulfill this HIV/Aids and sexual and reproductive health initiatives, or by she is HIV-positive, while her husband is not. She finds that
role, as well as the executive directors of the organizations advocating for the involvement of specific populations like her husband does not like to use male condoms, but he is not
involved. Every person or organization has certain skills, people living with HIV/Aids, youth or women. Depending on the opposed to female condoms. So they use them, but they are not
contacts, and expertise that complement others. current policy debates and developments, your message may regularly available. This increases the risk of infection with HIV/
be more specific. Advocacy messages should always demand a Aids as well as unintended pregnancy. We need to protect our
In the advocacy network, it is recommended to come up with policy change. population and you could play an important role in achieving
a joint advocacy strategy to maximize impact and to avoid this. Your support to a higher budget allocation to female
a variety of messages being delivered to decision makers. There are different kinds of messages that will enable you to condom procurement and programming would be of great help
There may be challenges too, people and organizations in reach your objectives and overall goal. This depends on the and we would like to ask you to share your expertise with us on
your network may have conflicting ideas or expectations of level of support of the target audience. the budget process and to support the amendment to the budget
the advocacy process. You may avoid conflicts by making that we are proposing.”
agreements amongst each other before starting your advocacy You can use sensitization messages to reach those decision
strategy together. makers who do not know much about the problem, or the Keep in mind that the way in which you deliver the message
solution, or to what extent he/she has an influence in changing is as important as the content of the message itself. When
You may also find support among influential independent it. It is not likely that this category of decision makers will presented orally, the message should be supported with
individuals in society, who have access to decision makers and support female condom promotion. Therefore, your messages convincing body language and use of voice. When the message
are willing to support your cause publicly. These people are should be more descriptive but nonetheless convincing and is written on paper, it should look attractive, the “tone” of the Mascot for the female condom campaign in Cameroon, girl wearing
often referred to as “champions”; they may be First Ladies, ex- supported by evidence. Factsheets or sensitization meetings language and use of sentences should appeal to the target female condom dress
members of parliament or government, or religious leaders. are helpful. You may also involve media in this sensitization by audience.
publishing items about the female condom. 51
3.7 Raise funds
When the decision makers or policy actors have gained more 3.6 Channels of communication The funding of your advocacy efforts should be included
understanding of the problem and your advocacy goal, you may Messages may be disseminated in different ways. The channel and budgeted for in your overall program design. In specific
start to convey messages with a specific ‘ask’. You will need to you choose depends on what would be the most effective cases, additional campaigns that you did not anticipate may be
let them know how they can take action. The elements of a one- to reach your target audience. As discussed in the previous necessary, which would merit a search for additional funding.
minute-message (or elevator pitch) may be helpful: section, for the purpose of sensitization factsheets, policy When advocating in a network of organizations and individuals,
reviews and informative workshops are a good way to convince you may make agreements on who funds what and how much
The one minute message52: decision makers. When a person that you are targeting when executing the advocacy strategy.
is knowledgeable on the subject already, he or she may
STATEMENT + EVIDENCE + EXAMPLE + ACTION DESIRED alternatively be reached with specific ‘asks’ in letters and face-
Statement. In a couple of strong sentences, you express the Seyi Jamoh, hairdresser and HIV positive
essence of your message Decision makers and policy actors need information, Lagos, Nigeria, 29 October 2009
publications and samples of female condoms. They should be “I talk about sex very openly. I just tell people that they
Evidence. The statement should be supported by facts and/or sent or given relevant material about your organizations and must use condoms. Then they ask: “Me? What have I got
figures to show the importance and urgency of the problem. your goals, like an information sheet presenting the cause, to do with a condom? I don’t have any diseases.’ I explain
its goals, objectives, and target groups, areas of intervention, to them why it’s important. I also talk to young girls. They
Example. Facts are important but also abstract. You should add intervention strategies and implementation partners. Face-to- must know what they’re doing. If you can’t abstain, I tell
a human face to your story, which can be an anecdote based on face meetings are important to build relationships. Sometimes them, use condoms. I’m not in favor of abstinence; I just
a personal experience. it helps to invite foreign guests or media to the meeting to give know it doesn’t work.”
the decision makers an opportunity to commit publically. Media
Bishop Jolly Oyekpen of the Anglican Church, advocate for female Action desired. Explain what the decision maker should do. It involvement is important in positively influencing opinions
condoms in Nigeria should be an invitation to act! about the female condom of government and the general public.
51 Based on IPPF (2009), Generating Political Change, using advocacy to create political commitment, page 12.
52 Networking for Policy Change: An Advocacy Training Manual by POLICY (January, 1999), page III-54. http://www.policyproject.com/pubs/AdvocacyManual.cfm 53 See chapter 2: How to govern your female condom program
Case Study Nigeria
3.8 Develop your implementation plan 4. Creating conducive environment outside of the policy
All of the above steps compiled will result in your field
implementation plan, indicating the issue at stake, your overall In this chapter, advocacy is being presented as a process that At the start of the female-condom program in Nigeria, the appreciate it when they are shown respect and feel that they
goal and objectives, your time frame and budget, who will be targets policy and decision makers exclusively. It is important Society of Family Health (SFH) was concerned that some should be the first to be told about the project to be carried out
providing support, whom you will be targeting, how you are to note that there are many other people and institutions that communities may not welcome the introduction of the female in the community. The community leader is also involved by
going to identify messages and which communication channels exert influence and that may help you to create a supporting condoms. SFH and Girls’ Power Initiative (GPI) and the CBO asking him which methods he thinks will be most effective in
you will use. Specific activities may be added. See Annex 4 for environment for your female condom program. These may located in Edo State identified strategies to gain access to the achieving the goals in his community. In this way, it becomes
an example outline of an advocacy plan. include community leaders, other gatekeepers, and donor communities and acquire their trust. even clearer that his assistance is needed to carry out the
institutions. project in the community.
It is important to try and document commitments from decision First, the traditional leaders, known as the Odionwere or Ogie,
makers so you can hold them to account. When a minister were visited. Even though not said in so many words, according At the initial visits, a “friendly face” (this could also be the
gives a speech about his support of the female condom, you 4.1 Community leaders and gate keepers to tradition first time visitors are expected to bring a gift of community leader himself) was identified and phone numbers
may publish an article quoting him/her on your website or in In the areas where female condom activities are taking place, some sort to the palace. The guests are usually in the company were exchanged. By doing this, GPI keeps in touch with the
media publications. Crucial in advocacy is the follow-up on it is important to recognize and engage the community leaders of two or three elders and they bring drinks and kolanuts as community from a distance which is especially useful when
commitments to make sure that they are actually translated into and gatekeepers. Community leaders and gatekeepers will often gifts. It is important to be aware of local etiquette and customs something urgent takes place.
real actions. Keep reminding relevant decision makers about share your concerns about the health and well being of the when starting a program as it will help to ease access to the
your cause, what they may do to contribute, and what they have people in their communities. It is helpful to look for common community. It takes time and effort to engage community leaders and
committed to. ground and how female condoms may contribute to alleviating gatekeepers. However, in Edo State it turned out that this
their concerns and the problems that exist in their communities. SFH and GPI then selected contact persons in the communities approach was successful and that communities were quite
This will allow you to emphasize the added value of your female to organize visits because they themselves had no way of receptive. By gaining support from community leaders, people
3.9 Ongoing steps: Data Collection and Monitoring. condom program by adopting their perspective. approaching the leaders. As well as gifts, materials such as were assured that the female condom program was addressing
All steps in the advocacy process are to be supported by newsletters, posters, leaflets, information bulletins and female their needs and benefiting them. The people were generally
relevant data. The environment in which you are executing your They should be aware of the program’s objectives and activities condoms were brought when visiting. Community leaders excited and curious to find out about the female condom.
advocacy plan is dynamic. This means that the policy arena to facilitate the implementation process in their communities.
needs to be monitored closely. Also, you need to keep a close Ideally, apart from giving consent to the program, community
eye on staff turn-over in the government. What is more, new leaders and gatekeepers should also promote the female
trends may gain popularity or new factual information may condom among their constituencies and facilitate field
come up that requires you to adapt your original plan to fit the activities. Another way for them to be involved and supportive
new situation. You should check your progress on your short- may be found in logistical matters e.g. arranging meeting spaces
term objectives bi-annually. If necessary, you may have to adapt for sensitization meetings or helping to mobilize community
your short-term objectives to the changing circumstances that members. This requires long-term relationship building,
your monitoring assessment may reveal. sensitization, and training sessions. Follow-up visits with 4.2 Donors and other institutions
these leaders and gatekeepers help to address concerns and The field of sexual and reproductive health, family planning and Did you know...
questions. It also demonstrates that the implementers of the HIV/Aids field involves many players. Apart from government ...That advocacy for the acceptance of the female
3.10 Evaluation program are willing and making an effort to work within existing and civil society, there are donor institutions like UN agencies, condom is carried out at all levels: from the Prime
Evaluating advocacy is difficult: you can not know for sure if community structures. the Global Fund to fight Aids, Tuberculosis and Malaria, Minister to gatekeepers?
a policy has been changed due to your efforts alone. There embassies and foundations. If there is an embassy or donor that
are new trends in evaluating advocacy, which look at other You may come across leaders who are not convinced or even is particularly supportive to the cause, it is important to invest
outcomes apart from the policy outcomes. 54 At the start of your oppose the female condom and the planned activities. However, in that relationship because they can be powerful advocates
advocacy process, you should identify indicators that allow you their support or approval may be very important for the for more funding from other donors. Mapping of these
to evaluate your progress a couple of years later. Examples of program’s implementation. In that case, it is important to make stakeholders55 will help to assess whether they can contribute
indicators are: sure that there is a continuous dialogue between you and the to the female condom program in terms of support or funding. Uchugba Agsigi, motor taxi driver
opponent(s) to show them that the program objectives address Media plays a big role in creating supportive environments as Benin City, Nigeria, 2 November 2009
• Level of funding for female condoms increased public health concerns and that this will benefit the people. well. How to involve media is discussed in the chapter 4: How to “I recently heard a radio jingle advertising female
• # of decision makers or policy actors reached It may be easier to talk about public health rather than about communicate with potential users. condoms. And I was at an information meeting about
• # of public commitments of decision makers or policy actors condom use when this is a particularly sensitive issue. Religion them. Yes the female condom is very good; naturally, it
• # of occasions in which you participated in policy dialogue may play a role in opposing the female condom. In some prevents diseases, and it sees to it that you don’t infect
• # of media articles published which are calling for policy countries, it may be beneficial to involve church congregations. others. You never know who’s infected with what. When
change In cases where religious leaders have difficulties supporting the you meet a girl, you don’t know what she has. With this
female condom, it is helpful to continue to have a dialogue with we can protect ourselves. It’s a good product. It’s nice
them to have them communicate at least neutrally about the and soft; you don’t notice anything.”
54 The publication of IPPF (2009) refers to good literature in this field. IPPF (2009), Generating Political Change, using advocacy to create political commitment, page 13. 54 Refer to Bibliography and Further Reading for an online power mapping tool.
Global Campaigning for Female Condoms It also provides a good photo opportunity for the media as the
Zawadi Smartlove travels all over the world to tell people about dolls make a beautiful colorful chain.
the importance of the female condom. Zawadi is a paper doll,
and there are thousands more like her. She is the heart of the International advocacy
Female Condom Paper Doll campaign of the Universal Access An initial collection of 400 Zawadi paper dolls from over 20
to Female Condoms Joint Programme. The campaign aims to countries were presented at the United Nations High Level
combine awareness-raising in different countries and advocacy Meeting on HIV/Aids in New York in June 2011. This collection
efforts at national and United Nations level. was used to bring the demand for female condoms to the
attention of world leaders. The complete collection of dolls,
People from all over the world write down their message comprising of more than 1,000 from over 30 countries will Amaka Nneji demonstrates the female condom on
demanding female condoms on Zawadi paper dolls. These dolls be presented at the ‘Prevention, Pleasure and Protection’ the market in Lagos, Nigeria
are then collected and made into a long chain, representing International Conference on Female Condoms in The
the worldwide demand for female condoms. The strings of Netherlands in November 2011 where they will be presented to
dolls send the powerful message that there is a great demand UNFPA, the Dutch government and others.
for female condoms, from people all over the world. Female
condoms can help to solve two of the greatest challenges the Connecting the dots: Social Media
world faces today: HIV/Aids and unintended pregnancy. Via Facebook and Twitter, messages and pictures from the Tips & Tricks
different campaigns from all over the world are uploaded
Local awareness raising regularly. All people participating in the campaign can see • Analyze the context in which you will be working and define need to be convinced? Also, it is valuable to know who
The NGOs participating in the campaign use the paper dolls who else is involved, and what is happening. This way the your issue accordingly. opposes your aims and may do damage to your efforts.
in their sensitization and awareness- raising meetings. The participants are not only connected to those organizing the • Set your overall goal and related objectives thoughtfully: Try to build a dialogue with them to convince them to
participants of such meetings can then have an active role campaign, but also to one another. You can also join the what kind of political commitments will contribute to the communicate at least neutrally about the female condom.
by writing their message on a paper doll knowing that these campaign by befriending Zawadi Smartlove on Facebook or female condom program? Make sure that your overall goal • Develop a concrete and convincing advocacy message.
messages will be presented to local as well as international following her on Twitter. and objectives are ambitious enough but also realistic. • Select your channels of communication thoughtfully.
leaders later on. The Paper Doll Campaign now has over 30 • Define your target group: who has most influence? Who • Reserve adequate funds in your overall programming
NGOs participating, from Argentina, Cameroon, Costa Rica, A participative campaign would be a useful gatekeeper? budget to cover your advocacy efforts and/or prepare to
Kenya, Liberia, Mexico, New Zealand, Nigeria, Rwanda, Local NGOs were not only asked to use the dolls in awareness • Build support for your cause by involving government raise additional funds for unforeseen advocacy projects.
Tanzania, Thailand, United States of America, Venezuela and raising and sensitization meetings. Because the paper dolls officials, community leaders and other gatekeepers from the • Appoint an advocacy officer based on a specific skill set
Zimbabwe. were designed taking into account input from NGOs from start of implementation. and personal characteristics, or allocate enough time
different parts of the world, the dolls are, in this way, ‘owned’ • Analyze your support base: who are your supporters and for the overall operational team to engage in advocacy
Local advocacy by them. The names of the dolls – three women and one man can help with your advocacy interventions? Which parties activities.
Once an NGO has gathered 50 messages or more, they are sent – were also proposed and voted on by the participating NGOs are doubtful about the use of the female condom and
back to the Netherlands, from where the campaign is organized. and on Facebook. Representatives of participating NGOs spoke
However, before the dolls are sent back, they can be made into at the event at the United Nations in New York. These and other
a chain and a ‘fare-well party’ can be organized after inviting forms of participation have been used to strive for ownership of
local stakeholders, politicians and the media. This provides the campaign by its participants.
an advocacy moment and an opportunity to ask local leaders
to write a commitment concerning female condoms on a doll.
• Condom use is a challenging subject for some leaders. Invest
in a dialogue with them for them to support the female
condom or to at least communicate about it neutrally to their
• Community leaders may want a share of the donor fund if
they see that there is a substantial amount of money involved
in a project reaching out to their community. Find out what
an appropriate reaction may be within the given context.
Positive Women Inc. and the YWCA of Aotearoa New Zealand
56 have joined the International Paper Doll Campaign 57
Chapter 6. Procurement and Supply Chain Management
The availability of the female condom is of the utmost wherever the female condom is sold or distributed, time and 2. What is procurement?56 outlets and peer educators in the communities with their supply
importance to the success of your program. Once potential space should be available to make the user feel comfortable Procurement refers to the process of purchasing the female of female condoms.
users have been localized, sensitized and encouraged to and to educate him or her. Outlets used for the sale of other condom from international manufacturers and getting it into
actually use the female condom, it should be available contraceptive products, such as dispensers and condom your country. It is an extensive process that includes the International procurement of female condoms is a complex
for the user, at all times, and at a variety of allocated machines may therefore initially not be effective for female following steps: process, and the duration of shipment may be inconsistent. It
places. New users have not reached a stable level of condom sales. Female condom programming thus requires the 1. Purchase planning: Purchase planning involves the search can take anywhere from a few days to several months to get
consumption. Therefore, it is of great importance that they identification of new outlets and, additionally, it may be the for the supplier of the product that you need as well as the female condoms shipped to your country. Beware that
are not discouraged from using the female condom, simply case that these outlets have no prior experience in supply chain quality control. The Female Health Company manufactures this inconsistency may disrupt the planning of your program.
because of a lack of availability. Proper procurement and management. Also, when existing outlets for other contraceptive the FC2 female condom in a factory in Malaysia, the Women’s Furthermore, the customs clearance of the products may require
supply chain management is pivotal in ensuring the option products include the female condom in their business, staff Condom is manufactured by Dahua in China, and the Cupid a lot of paper work as requested by the authorities, specifically
of sustained use, which requires a long-term structural members need to be trained to be able to adequately provide female condom is manufactured by Cupid Ltd in India. 57 the pre-embarkation inspection certificate. It is recommended
process to make sure that the product is able to keep information on how to use the female condom. 2. Price negotiation: The price you pay to the manufacturer to be well informed about related procedures, so as to avoid
moving in and out of the market smoothly. directly influences the price you are going to have to ask of major delays that will result in the unnecessary spending of
This chapter describes the entire Procurement and Supply chain the user. Because the cost of the female condom may be an program funds. If you are not eligible for tax exemption, it is
Management system for the female condom: from procurement, obstacle for the user to buy it, it is important to put great generally less costly to get a larger quantity of female condoms
1. Introduction: Availability is key to storage, to distribution mechanisms. In addition to logistics effort into negotiating a good price with the manufacturer. shipped and cleared at the same time. However, make sure
When (potential) female condom users go to a sales point and and administration, Procurement and Supply chain Management 3. Making the purchase: This requires significant paper work that your organization has sufficient storage and distribution
realize that the product is not readily available for purchase, is about internal communication. It is important that the and signing of contracts. You need to make agreements capacities. If not, this can cause problems in terms of expiry
this will result in disappointment and will likely negatively different stakeholders in your program that are responsible about the amount of female condoms purchased, the dates and storage capacity.
influence sustained use. Hence, availability of the female for PSM communicate with one another clearly and effectively, price that will be paid, the time frame of shipment, what
condom is key. Sustained availability of the female condom will to ensure that procurement, shipment, and distribution to to do in case something goes wrong in the procurement
encourage product uptake by new users as well as repeated use warehouses, outlets and peer educators runs smoothly. process, etc. Your contract with the manufacturer needs 4. Testing
of the female condom as a preferred contraceptive choice. to be actively monitored and your relationship managed.
This should include appropriate risk mitigation strategies
Availability of the female condom is supported by a process and subsequent early corrective actions, if needed. If the
called Procurement and Supply chain Management (PSM). purchasing is a continuous process, long-term agreements
Procurement and Supply chain Management is the process may be made with the manufacturer.
of purchasing the female condoms from the manufacturer, 4. Establishing inventory control mechanisms: This is about
shipping them to your country, storing it in warehouses and overseeing the constant and adequate supply of female
depots, and organizing the logistics to get the female condoms condoms, avoiding over-supply, or the products being out of
to outlets, CBOs, public health centers and peer educators. The stock. Consistency may be ensured by establishing a team or
overall goal of PSM is to make sure that your product is moving staff person to oversee the supply in the central warehouse.
around continuously, i.e. that all segments of your supply chain This will allow you to anticipate the need to purchase new
are continuously stocked. This chapter describes the different stock, whilst taking into account the time it takes to purchase
stages in procurement and supply chain management. It also and ship. Female condoms are tested in this testing lab in Cameroon
describes the different distribution strategies that you can pick
from, e.g. distribution free of charge, offering samples, selling The procurement of female condoms is often conducted by The lead organization should always ensure that condoms are
subsidized products, and selling at a profit. governments, donor agencies or United Nations agencies, such being checked by the appropriate institutions that have been
In Nigeria condoms are sold under the name “Elegance” as UNFPA. Please note that currently, UNFPA procures only the charged with quality control to ensure that condoms comply
When engaging in female condom programming, PSM is generic FC2 female condom to the public sector. If you are to with the quality standards and are not counterfeit products.
inevitable. It is important to be aware of the fact that managing proceed your programming by using a type of female condom Some countries, depending on their national pharmaceutical
a Procurement and Supply chain Management system truly is that has not been approved by the current pre-qualification legislation, require local quality testing of the product before
a profession in itself. Some organizations may have expertise Ndoumbe Lindgen Hans, Wholesaler agencies FDA or WHO, you will need a risk mitigation strategy. 58 receiving permission to distribute and sell it. The testing
in this field, whereas others may have never engaged in it. You Douala, Cameroon, 6 November 2010 laboratory tends to be part of government infrastructure. To
may be responsible for all or for part of the PSM, e.g. you may be “I think there is a high demand for the female condom. illustrate: in the case of Cameroon, the government has been
procuring the female condoms from the manufacturer, or you I work with doctors and humorists to pass on my 3. Shipment and customs clearance testing the female condoms that were entering the country. As
may be charged with ensuring that your peer educator and your message. Sales have been increasing because I started When female condoms have been purchased, the lead a result, the government is now assured that quality products
drug store owner have a sufficient stock of female condoms with 1O cartons per month and now I’m selling 5O cartons organization of the program will receive timely information are entering the country and will be able to identify counterfeit.
available. every month. I sell mainly to establishments, which do regarding shipment. The lead organization should make sure Consequently, the government of Cameroon is now supporting
not necessarily retail them. For example, I distribute to that all stakeholders in the supply chain system are on stand- the female condom. In other countries, pre-tested female
Procurement and Supply chain Management for the female companies that have health centres. These centres have by, e.g. the staff in the central warehouse and in regional condoms may enter the country without further testing as they
condom is distinct from that of other (contraceptive) products, anti- HIV/AIDS programmes, but they lack the means. warehouses and the staff driving the vehicles and supplying the comply with international quality standards.
like the male condom. This is because female condom So if you arrive there with an STD, you are doomed.”
programming targets both men and women that visit a variety
of distinct outlets. Additionally, female condom promotion and 56 The four steps are based on the definition of Procurement from www.businessdictionary.com
57 New products by other manufacturers are under development.
sales need adequate education and counseling. This means that, 58 Please refer to the Frequently Asked Questions annex.
5. Wrapping and packaging usually done in-country to avoid high costs and to be as time- thumb is to send stock to facilities at least 6 months before it 8. Distribution through different channels
The female condoms that you procured may arrive in your efficient as possible. expires. This will ensure that you will have enough time left The most important question in terms of supply chain
country in one of two ways: With regard to scenario (1a) and (2a), a concise user manual may to distribute and sell it. management is: how does the product get to the end user? A
1. They either arrive in a generic factory wrapper, or; be developed that is included in the package that goes to the 5. Storage conditions: Storage conditions vary per female diversified and reliable distribution network is crucial in getting
2. They are already branded when they arrive in your country end user. condom type. You should inquire with the manufacturer to the female condom to its user. The user needs to be able to
based on your negotiations with and instructions to the find out if your stock needs specific storage conditions. As rely on the steady availability of the product, e.g. when going
manufacturer. Therefore, they will be in your own uniquely the FC2 is resistant to humidity as well as high temperatures, to a certain outlet or peer educator, he or she needs to be sure
branded wrapper. 6. Storage59 its storage does not require special conditions. Different that the female condom will be available there at all times.
Planning the storage of your female condoms in a warehouse types of female condoms may require different handling. Additionally, the person selling the female condom needs to
Based on the marketing strategy you have chosen, additional takes time and thorough planning. Your warehouse is a key be well informed and trained so as to be able to offer proper
packaging may be necessary upon their arrival in your country. facility in your supply chain and distribution strategy, and it information and counseling. Furthermore, diversification
is of the utmost importance that it is regarded in this way. The 7. Transportation of outlets ensures stability in sales rates and accessibility.
When scenario (1) above applies, you may (a) package the following aspects are particularly important: The operational team of the female condom program plays an Distribution networks can be communal, pharmaceutical,
generic female condom in an additional branded design important role in distributing the female condoms from the public, and commercial. Distributing the female condom is best
package that is provided by the lead organization to central warehouse to regional or smaller warehouses. From done through existing distribution networks and supply chains
complement the generic wrapper that it was provided to you there, the female condoms will have to find their way to outlets, of other medical or reproductive health products.
in; or, (b) you may leave it in the generic wrapper that it was health clinics, CBOs, and peer educators. Sadly, it sometimes
packaged in at the factory and distribute it like that. happens that stocks of female condoms remain in the central When the female condom is newly introduced in a certain
warehouse due to the lack of a good supply chain management country or region, a lot of time needs to be invested in inter-
policy. You should attempt to avoid this at all times! personal communication. Therefore, at the start of a program,
distribution and sales tend to go faster at sales locations
Talye Elijah, man on the street, who had just bought a female After shipment and clearance, the lead organization may use where there is space and time for education and counseling.
condom two different ways of transferring the goods from the harbor to Despite the fact that regular stores and supermarkets are easily
Lagos, Nigeria, 29 October 2009 the warehouse: accessible to the user, it may take some time before sales start
“When I saw the posters up at the hairdresser’s, I went 1. by using its own logistical structures and vehicles, or; increasing in these places, as staff here often does not have time
in to ask what they were and how they worked. I became Condoms are stored in this warehouse for ACMS in Cameroon 2. by contracting agents to transfer the female condoms to to engage in education and counseling.
enthusiastic immediately and tried one out. I run my own central warehouses.
shop around the corner, in cosmetics. I am also going to 1. Location: The warehouse building must be located at an
sell female condoms. I’ve just heard where I can order appropriate location so that it allows you to meet your Costs related to customs clearance and the transfer of goods
them. They’ll be in my shop from next month. They’re so clients’ and customers’ delivery requirements. It is also needs to be properly budgeted. Transfer of products from Irene Aimee Kubisa, owner 3rd Millennium Hair Salon
good, everybody must use them.” important to consider the availability of laborers as well as central warehouses to decentralized stores must also be well Douala, Cameroon, 5 November 2010
road access in this respect. funded to ensure the steady flow of products. Warehouses, “It was difficult at the beginning because women did
2. Managing storage: The areas in which you will store your depots, and vehicles are often used for different products at not know about the female condom. So women had to be
stock of female condoms needs special care. The areas the same time. The use of vehicles however is context-specific trained on how to use it. Sales are now picking up. We get
used for receiving and storing your stock must be prepared and often depends on funding. Transporting female condoms monthly supplies, so we always have sufficient stock. I
and cleaned. Packages must be inspected to make sure that may be regarded as less of a priority as compared to the other have customers who buy a carton of 1O condoms every
damaged products are being separated from usable stock. If products that need transportation. It may therefore be helpful to month. I also have customers who stop by once in a while
damaged products are discovered while the delivery truck allocate specific vehicles for transportation of female condom to get the female condom.”
is still at your site, you may refuse to accept the products. If stocks.
damaged products are discovered after the delivery truck
has departed, you should follow the procedures for handling Within the lead organization, a supply chain manager or PSM 8.1 Community-level: Peer educators and CBOs60
damaged stock. team should be available to design an appropriate PSM plan, Inter-personal communication (lPC) sessions by peer educators
3. Arranging stock: Female condom boxes are arranged to manage all activities in the warehouse and storages, and to and CBOs are an effective way to present the female condom
on pallets. When stored, the pallets must be at least 10 procure and supply the program with a steady amount of female to a wider audience. It equips potential users with essential
centimeters above floor level, at least 30 centimeters away condoms. information, and offers them an opportunity to have a look at
from walls and other stacks, and can be stacked no more and even touch and feel the product. Arousing the curiosity
Female condoms in warehouse in Nigeria than 2,5 meters high. The following information must be of your audience may lead them to eventually want to try the
clearly visible on your boxes: labels, expiry dates, and female condom. Peer educators may reply to questions or
When scenario (2) above applies, you may (a) package the manufacturing dates. Did you know... concerns on the spot. People tend to feel more comfortable
branded female condom into a box or other type of package that 4. Stock rotation: When issuing products, it is important to ...That the social marketing programme in Zimbabwe purchasing a female condom from a peer educator than from
complements the branded wrapper that is was provided to you follow the FEFO policy: “First Expired, First Out”. To facilitate has over a thousand hair salons and barber shops other points of service.
in; or, (b) you may leave it in the branded wrapper that it was this, it is easiest to place products that will expire first in distributing the female condom?
packaged in at the factory and distribute it like that. Step (2a) is front of products with a later expiry date. A general rule of
59 This section draws from “Guidelines for the storage of essential medicines and other health commodities”, by DELIVER, JSI, WHO, UNICEF and USAID, December 2003. 60 Refer to chapter 3: Community Approaches and Chapter 4: How to communicate with potential users for more information on the work of peer educators and CBOs.
10. Distribution 10.2 Selling the female condom
Distribution can be done in several ways: distribution free of Selling the female condom has certain advantages over free
charge, selling subsidized products, giving out samples, or distribution. First and foremost, distributors tend to be more
selling at a profit. interested in getting the product to the user if they will make
a profit. At the same time, in the process of selling and buying,
there is time and space to educate the buyer in how to use the
product. If the user visits the same selling point over and over
Dr. Rudolf Kunchu Nintai, Pharmacist at Noble Pharmacy again, it is easier to follow and locate the user and find out
Bamenda, Cameroon, 2 November 2010 whether the product has been used correctly and in a sustained
We sold 2O female condoms in September when the manner. Lastly, some people may appreciate the product more
schools were reopening. That’s our average sales per when they are paying for it.
month. Some parents came here with their sons and
daughters. I can confidently tell you that when the Selling the female condom can be done in two ways:
schools were reopening, one parent came here with • Subsidized: Since female condoms are more expensive than
her daughter and she bought quite a quantity of female male condoms, people may choose not to buy the female
condoms for her. The daughter was laughing but she condom for that reason and even not to try if the female
took them. I was happy and gave them a few more free condom is an option for them altogether. That is why selling
Elvis Oviasuyi and his wife in their chemist shop in Nigeria where they samples. Maybe when you visit next time we will be able the female condom at a subsidized price may contribute
sell female condoms to update you on this trend. Hopefully, sales will go up in to greater accessibility. This is often done through social
the future. marketing.61
Elvis Oviasuyi, pharmacist • For profit: Female condoms are sold for the actual cost of the
8.2 Pharmacies and drug stores Benin City, Nigeria, 2 November 2009 product, plus a small margin which will profit the seller. This
Pharmacies and local drug stores tend to be visited by “I’m now trying to sell them in my shop. There clearly is a 10.1 Distribution free of charge is usually the case in the commercial sector. For the female
customers seeking non-prescription medicines and health demand. Women, men too, want to buy them. But stocks Giving out the female condom free of charge has a major condom this is still uncommon. Because it is a fairly new
products. Local drug stores, which are often small-merchandise soon run out and at the moment I can’t get new stocks. advantage in the accessibility of the product: in this way, the product that addresses major public health concerns, it is
kiosks that include the sale of non-prescription health items, are When I had them, we sold a box of 24 every day but, if cost of the product is not an obstacle for women and men to subsidized and made available in through the public sector
located in even the remotest villages and are therefore perfect more were available, sales would certainly double.” buy and try the female condom. It also increases the visibility in many countries. For now, the focus is still on accessibility
outlets for selling the female condom. of the product, which can contribute to its normalization. Free and normalizing the product as a contraceptive choice.
distribution is often done through the non-commercial sector, Therefore, subsidized pricing is still the dominant sales
9. Keeping Stock e.g. through public health centers, but also through NGOs/CBOs strategy.
8.3 Non-traditional outlets The key to encouraging users’ confidence in and sustained when a donor purchased the female condoms to be distributed
The female condoms may be sold in a variety of outlets. use of the female condom is in its availability. Once demand freely. In order for private sector parties to integrate the female
Supermarkets, hotel reception desks, hair dressing salons, for the female condom has been created, the product should condom into their regular stock, incentives need to be created
barbershops, street vendors, and roadside kiosks are examples be available for purchase or hand out at all times. A staff Alternatively, free distribution of the female condom may to make it worthwhile to invest time in training and capacity
of non-traditional outlets for the female condom. Involving member should be appointed to oversee that all sales points present difficulties, some of which are mentioned below: building to educate the consumer on how to use the condom.
these outlets in your network increases access to the female and dispensers are restocked before running out of product. • Education and counseling opportunities: People need proper Incentives for private sector partners include the prospect of
condoms for both women and men. Additionally, offering Keeping stock properly is what builds your organization’s instructions for correct use and need to be reassured that it making a profit and of expanding their customer base.
the product in places that people visit in their daily routines reputation and reliability. needs practice. When giving out female condoms for free,
contributes to normalization of female condom use. there may be less of an opportunity to talk to the potential
Keeping stock ultimately starts by making sure enough product users and to address their questions and concerns. 10.3 Sampling
reaches your country, so that you can adequately respond to • User identification: When the female condoms are being Female condom use needs practice before women and men
8.4 Public health system the demand. Transportation systems, warehouse and storage provided in dispensers in public places or handed out for will choose it as their preferred contraceptive method. Free
The female condom may also be distributed through your management need to function properly in order to keep free, it may be difficult to identify users and find out whether sampling enables potential users to try it, before they are
public health system. Often, the government is responsible for your stock flowing. Both outlets and peer educators carry they have used the product correctly, what their experience willing to actually pay for the product. Sampling is often done
supplying the different public health locations, which can be responsibility for monitoring their stock and asking for more was, and whether they are interested in using the female with socially marketed female condoms and in the commercial
pre- and post-natal care services, family planning centers, and stock well in advance of running out. Some organizations condom more often. sector. A successful way of sampling is to offer the user a “buy
HIV/Aids voluntary counseling and testing (VCT) clinics. appoint a sales team, which monitors the stock and sales of all • Trust: Some people may be suspicious when receiving things one, get one for free” deal.
outlets in a certain region. Stocking is best done through a “First for free and would rather pay a little money so that they will
In, First Out” (or a “First Expired, First Out”) principle to prevent feel as if it is a trustworthy product.
product expiry. It is important to keep the “pipeline” stocked, • Other purposes: Freely distributed condoms may be
meaning that all segments of the supply chain (warehouses, resold to a third party or used for other purposes than as a
Did you know... depots, outlets, peer educators and CBOs) should have stock contraceptive method.
... That two of the 16 CBOs have health care facilities? at all times. This means that you will need to purchase more
products than you are expected to sell or distribute.
61 See chapter 8: Creating demand, increasing access.
Non-Commercial Social Marketing Commercial 12. Corporate Social Responsibility 13. Female condom demonstration models
An approach worthwhile exploring may be the engagement Female condom demonstration models are used for female
Free distribution X of private sector companies, such as soda companies or condom training and demonstrations. A demonstration model
food suppliers, so that they may help distributing the female shows the labia and vagina up to the cervix. The representation
Sales: subsidized X condom by using their national distribution networks. For is simplified for didactic reasons and is designed so that
them, contributing to the improvement of general public it offers you the opportunity to properly demonstrate
Sampling X X health by offering distribution services will be perceived as a the insertion of a female condom. To ensure efficient
social responsibility. Field marketeers and merchandisers may training, education and inter-personal communication, it is
Sales: for a profit X promote the acceptability of female condoms along with their recommended to make sure you have enough female condom
products, thereby ensuring product visibility. Local wholesalers demonstration models available for every staff member that
that work with these private sector companies will often turn is involved in these activities, e.g. trainers, trainees, peer
out to be key distributors for liquor outlets and grocery shops in educators, community leaders, barbers, hairdressers, etc.
11. Complementary approach ones monitoring female condom distribution channels of the remote areas. This will offer you the opportunity to more easily Hence, it is essential that you budget accordingly to allow for
To avoid duplication and competition in the non-commercial, non-commercial, social marketing, and commercial sectors. distribute female condom stocks to remote areas. In return, the sufficient purchasing of models. It is important to note that
social marketing and commercial sectors, distribution female condom programmers may also encourage the pairing the process of procurement for female condom demonstration
channels should be clearly defined. The different channels are Note that, in some countries, the government may not allow of female condoms with other women-focused products in models is comparable to the one for female condoms. Hence,
complementary and can support each other when one of the identical packaging of freely distributed female condoms and hair salons to make sure it fits the companies’ regular business. you should plan well in advance!
channels faces difficulties in distribution and supplying. It is socially marketed female condoms. In that case, the socially Despite the obvious benefits of partnering with a private sector
therefore recommended to maintain close relations with the marketed condoms will need to be rebranded. company, do always thoroughly consider the implications
of association, e.g. openly linking your female condom to a
local beer company may have negative consequences for the
reputation of female condom use.
Case Study Cameroon Tips & Tricks
• Procurement and Supply chain management is all about • Make sure to closely monitor the stocks in your entire
impeccable planning! supply chain to ensure accessibility and availability.
• It is useful to appoint a supply chain manager or team to • You may apply a “buy one, get one for free” approach to
When starting the large-scale female condom program, female Subsidized sales aim to realize acceptance and adoption of oversee the PSM process. attract new users.
condoms were relatively new to people in Cameroon, and the the product. People who want to use the female condom can • Make sure to purchase your female condoms at least 6 • It is important to keep the “pipeline” stocked, meaning
product was faced with many prejudices. To counter these buy it for a reasonable price at different commercial locations, months prior to the envisioned start of your program’s that all channels in the supply chain (warehouses, depots,
prejudices and to create incentives to use the female condom, for example: implementation. outlets, peer educators, and CBOs) should have stock at
ACMS uses different distribution approaches: free distribution • Hairdressing salons, • Make sure to distribute your female condoms through a all times. This means that you will need to purchase more
and subsidized sales. • Pharmacies variety of existing networks and supply chains. products than you are expected to sell / give out.
• Commercial wholesalers.
Free distribution addresses the curiosity of the potential users
by letting them see, feel and try the product. Free distribution is ACMS now sees that the quantities of female condoms
implemented through: distributed for free are decreasing, as people in Cameroon
• The partnership with the Cameroonian branch of Society become accustomed to the female condom as a contraceptive
for Women and AIDS in Africa (SWAA), which receives 7,700 method. Nevertheless, ACMS continues to implement these two
female condoms each month; approaches as they rapidly give more publicity to the product
• Civil society implementing partners of the project and and further its acceptance.
hairdressing salons that receive samples;
• Companies and United Nations agencies that acquire female Buy one and get one free!
condoms for their employees; ACMS introduced a successful strategy to increase the user’s Did you know... Challenges
• Internal teams of the ACMS that distribute female condoms curiosity, acceptance and adoption in one go. They made ...That approximately 10 million FC1s and FC2s were
during special public events, such as International Women’s information leaflets which included two female condoms. They purchased and shipped by USAID IN 2009 making it • Bureaucratic procedures in procurement and customs
Day, World AIDS Day, and HIV voluntary counseling and asked the potential users to “buy one and get one free”. The the largest ever US female condom shipment during clearing may result in the inconsistent supply of your female
testing events. user received a 50% discount on the product and was given two a calendar year? condoms. This should be taken into account when you are
female condoms to try. This approach is very popular and works planning and budgeting for your program.
well immediately after the introduction: female condom sales • Keeping stock at all levels of the supply chain requires
increase immediately. profound logistical skills. Beware not to underestimate this!
Chapter 7. The involvement of men: It takes two to tango
Couples are at stake when it comes to decision making Context-specific strategies to involve and engage men in
regarding Sexual and Reproductive Health (SRH) and using the female condom are pivotal to overcome these
family planning. Hence in female condom promotion, social and cultural barriers. For example: female condom
men are an important part of the equation too. Female programming should promote partner support, consensual
condom promotion is not merely a matter of explaining sexual relationships and negotiation. Actively involving men
to women how to use the product. Rather, in order to be has advantages in this regard, such as the protection of the
successful, you need to address a variety of issues that may couple and the family, increased respect for the woman by the
be socially or culturally sensitive. Sexual relationships, man, promotion of gender equality, and overall acceptance of
sexual pleasure and sex negotiation between men and the product by both men and women. Men who use the female
women are not topics that many people will discuss openly. condom show that they are not only concerned about their own
These discussions form the backbone of our work and it is health, but also care about their partner and their relationship.
important to be aware of the fact that men and women need In this light, specific messages should be developed in order to
to be targeted equally in your programming. This chapter convince men that female condom use is worthwhile.
describes some of the strategies that you may use to target
and involve men in female condom promotion: by using
specific media campaigns, by adapting messages so that
they will appeal to men, by using specific role models, and
by identifying locations where you will reach men more Did you know...
easily. ...That in Nigeria, apart from married couples, mainly
young single men (age 18-28) are interested in the female
condom? (male involvement)
Did you know...
...That in Cameroon, Nigeria and Zimbabwe, barbers
act as peer educators for other men and their shops A group of men receive
serve as outlets for the female condom? information and instructions on how to use Did you know...
Lead trainer Nigeria: the female condom ...That in Nigeria, some men come along with their
“Men are more curious and ready to experiment the female partners to sensitization meetings and seem
usage of the female condom, and are more willing to more eager to experiment with the female condom
use it than women.” than women?
1. Introduction: What’s in a name?
“Female condoms” seem to automatically refer to women. In the Lady, Commercial Officer, Radio Hot Cocoa
past, female condom programmers have sometimes interpreted Bamenda, Cameroon, 3 November 2010
this as a reason to reach out exclusively to women. However—if 2. How to use the media for promotional purposes Why did you decide to promote the female condom?
you aim for your program to have a real sustainable impact—it Communications should initially focus on the couple (married “I wanted to create awareness about the female condom 3. How to adapt your messages to attract men’s attention
is important to be aware of the fact that men need to be or unmarried). To sufficiently attract men’s attention, media and to encourage not only the girls but also the boys to Reaching out to men means adapting the messages, locations
involved equally. Using a female condom requires both and promotion campaigns should also contain messages use the female condom, especially those boys who are and sensitization strategies to what men want to hear and
partners’ consent. Additionally, partner support in sexual that are attractive to men, that empower them to initiate a shy. where they can be found. Information, education and
relations and contraceptive choice is essential in promoting a dialogue concerning family planning and condom use, and that communication events should also target places where many
safe, healthy and pleasurable sex life, for both women and men: encourage them to buy the female condom. We mainly broadcast the advert. Many people get to men go, such as barbers, bars, work places, uniformed forces’
it takes two to tango. know about the female condom through these adverts. I camps, and market places. Some professions are executed
don’t use it myself but I persuade other women to use it. exclusively by men and provide a service to men, such as
Promotion of the female condom, being a women-controlled “Condoms for men who want the best for women.” We also use posters and calendars to promote the female barbers, policemen, taxi drivers, DJs, and journalists. It is very
method, therefore presents us with an additional challenge. Media campaign in Cameroon promoting the female condom. condom. Besides this, we had an interactive programme powerful if these men convey a positive message on the female
The female condom explicitly addresses the woman’s where listeners can call in to contribute by giving their condom as this may engage and convince fellow men.
sexuality, thereby empowering her to protect herself against opinion or asking questions. Some of the girls have
pregnancy, HIV/Aids and other Sexually Transmitted Infections. The involvement of men in the campaign will portray the female complained that when they wanted to use the female In terms of developing your message, it is important to include
Nonetheless, she will often face gender inequality and power condom as an attractive product for men who care for their condom the boys objected by saying they wanted to do a clear statement as to how the female condom benefits men.
imbalances in her sexual relations: in practice, it often turns partners. When broadcasting a video clip or commercial, there it naturally. This is a good reason for discussion. We try Please find some examples below:
out that women are targeted exclusively by female condom should be an appropriate balance between the number of men to talk about the consequences of unsafe sex. You know, • The female condom may be inserted into the vagina before
programming, whilst it will often be the man that decides and women that are being shown. Community radio stations the boys can easily convince a young girl to have sex the start of the sexual intercourse. So: no interruptions are
when and how to have sex. Hence, despite the fact that many offer another communication channel with which to reach out with them. This is why we find it really important to talk required in “the heat of the moment”.
programmers will agree that a focus on the couple is pivotal, it to men. When designing a promotion campaign, the wishes and about a subject such as the female condom. We try to • Men will feel free during intercourse, when using the female
nonetheless often proves to be difficult to meaningfully engage concerns of men should be included in the focus of the research convince the boys to always use a condom. We also have condom: there is no tight male condom around the penis
men in sexual and reproductive health matters in general—and that will inform campaign design. a Pidgin English programme where we talk about the use • Both partners are free from worries during sex as the female
in female condom use and promotion in particular. of condoms and the dangers of not using condoms.” condom offers dual protection against pregnancies, HIV/
Aids and other Sexually Transmitted Infections.
• The female condom offers a good method for showing care Marie Madelene Bakong, married and mother
for the woman, himself, as well as the relationship. Buea, Cameroon, 5 November 2010
• The female condom adds to joint sexual pleasure: both the “My husband did not want us to continue having children
woman and the man will enjoy. but he hated the male condom. So I got pregnant all the
time. Sometimes we would not make love for weeks
because of this. One day my hairdresser introduced the
3.1 Using role models to spread the word female condom to me when I came to have my hair done.
An effective way to convince men to try the female condom is by I took one home and tried to insert it myself. When my
having male role models in society spread the positive message. husband came home in the evening, I told him about
These may include musicians, football players, religious leaders the new condom I learned about but he was not very
or politicians. These role models will need support from the interested and still did not want to make love with me. I
stakeholders involved in the female condom program to convey came back to my hairdresser and she advised me how to
accurate messages. negotiate with my husband so that he would accept the
female condom. And behold, I used the right approach
and my husband got curious. That night he inserted the
4. Partnerships will contribute to your cause female condom himself. And he enjoyed making love Did you know...
In some countries, so-called “MenEngagement” networks with it. He even told me I should have told him long ago ...That in Cameroon, currently more men than women
mobilize men who will stir the public debate on gender that the female condom was much better than the male buy the female condom?
Elegance poster in Nigeria
equality, masculinities, and the sexual and reproductive health condom.”
of men and women. 62 These networks and NGOs can assist in
developing strategies to promote female condoms on the basis Did you know...
of gender equality in your country. ...That barbers sell more quantities of female
condoms than their female counterparts?
Tips & Tricks
• Make sure to appoint male peer educators. • Involve male role models to reach out to other men.
• Make sure to build your supervisory body on the basis of • Integrate female condom messages into other programming,
gender balance. such as programs focused on male condom use, male
• Involve men who work with fellow men on a daily circumcision, dual protection, and consensual sexual
basis, such as barbers, policemen, taxi drivers, DJs, and partnerships.
journalists. • Work with men’s (engagement) networks.
Case Study Mozambique • Make sure that your media messages and promotion • Positioning the female condom as a tool to ensure the health
campaigns for the female condom are male friendly: of both the woman and her partner.
emphasize how the female condom benefits both women • Position the female condom as a tool that adds to sexual
and men! pleasure and worry-free sex for both the woman and her
• Involve men in the design, implementation and evaluation partner.
of the female condom promotion campaign.
In Mozambique, Fórum Muhler and partners launched a pilot A result of this pilot initiative was the creation of the Rede de
initiative to get more men involved in HIV/Aids programs. The Homens pela Mudança (‘Network of Men for Change’) that today
aim of this pilot is to raise awareness among men concerning unites several civil society associations that are fighting for
the reduction of feminization of HIV/Aids. the promotion of gender equality. The Rede de Homens pela
Mudanca has performed various training activities targeting
In its first phase, the so called Parceiros H (‘Men as Partners’) the youth of the city of Maputo. It has also set up restricted
program was based on the training of young activists, discussion groups, engaged in public debates and campaigns
including young members of other Mozambican civil society against domestic violence. In addition, some studies have been Challenges
organizations. These initial trainings focused on themes like: done concerning the participation of men in promoting sexual
Gender and Masculinity, HIV and Aids, Gender and Violence, and reproductive health. • Strong social and cultural taboos surrounding sexual issues
Sexual and Reproductive Health, and Culture and Tradition. The may form a barrier to men’s involvement in the promotion
program covered three provinces in Mozambique. and use of female condoms. Make sure to design context-
specific strategies that may tackle related challenges.
• Messages that target men are different from those that target
women. Finding a message that helps to encourage men’s
involvement in family planning and condom use takes time!
For example, refer to the MenEngage Global Alliance: http://menengage.org
Chapter 8. Creating demand, increasing access
When the female condom as a contraceptive method is Most importantly, social marketing creates demand by
commonly unknown, it is most important to start your Joyce Adesanye, 56 years thinking from the audience’s perspective: don’t ask what
program by investing in awareness raising, the creation of Did you know... Church leader Omipanu neighborhood people need, ask what they want! All too often, marketing
demand and increased access to the female condom. This That in Lagos, Nigeria, the number of outlets selling Nigeria, Lagos, 29 October 2009 approaches take a patronizing approach of “we know best
may be done in a variety of ways and should ideally involve the female condom increased from 45% to 95% in “I’m a church leader of the Christ Church for All Nations. what is good for you”. This approach generally proves to
a range of sectors and stakeholders. This chapter highlights two years? I was there this morning. A woman who had lost her be counterproductive. Instead, there is a great opportunity
building partnerships with parties in both the non- husband just before her child was born spoke to me. to market the female condom as something that will help
commercial public and the commercial private sectors, and She’s alone. She’s still young. There is a new man seeing people to get what they want, e.g. sexual pleasure, peace of
how these may contribute to increased access to the female her; she doesn’t want any more children, so I tell her to mind, protection, control of sexual and reproductive health,
condom. Additionally, social marketing is emphasized as a 2. Partnerships with public and private sector players use the female condom when she sleeps with him. She etc.
useful way to connect the two sectors in creating demand as Female condoms may be made available by different players: wants to use them, so I’m making sure she gets them.”
well as greater and sustained access to the female condom.
2.1 Non-commercial, not-for-profit 3. Social marketing: Our good practice! Did you know...
1. Introduction: Team up and wise up! A. Government, (public) health: Female condoms may be As explained above, in both sectors —public and private— That in Cameroon annual competitions are organized
This chapter outlines the different sectors in society that you made accessible through public channels, which means they demand for the female condom is often lagging behind. In for hairdressers based on who sells the most female
may team up with to ensure access to the female condom. There may be available at government clinics and hospitals. Often, our experience, social marketing has proven to be a useful condoms? The winners in the different regions are
is the non-commercial not-for-profit sector that makes the governments collaborate with UNFPA to procure the type of strategy in creating demand and increasing access to the female displayed on a poster shown in all hairdressing salons.
female condom available in public centers like clinics, family female condoms that are pre-branded by the manufacturer. condom. At the same time, both the public and private sectors
planning centers, HIV/Aids voluntary counseling and testing They will usually offer them for free when a woman comes for are strengthened as social marketing works from within existing
centers, and at some NGOs/CBOs. Then there is the private her health check, for advice on family planning, or when she (distribution) structures. Overall demand for the female condom
sector that sells the female condom for a profit. Sales in this visits a HIV/Aids voluntary counseling and testing center (VCT) is generated through a carefully marketed strategy, which will 3.1 Four P’s
sector are often fueled by rebranding campaigns that help to or maternity clinic. In some cases, the client is asked to pay benefit both sectors. We will explain in detail below. Social marketing is best described according to the so-called
attract consumers. Additionally, social marketing may prove to a small amount for the female condom. Whether the female “Marketing Mix”, also known as the four P’s. A Marketing Mix
be an effective way to further create demand by addressing a condom is actually offered and available in the public sector Social marketing is a marketing approach that is applied to the strategy includes Product, Price, Place and Promotion strategies.
common public health concern. Social marketing refers to the varies from country to country. In many cases, the female promotion of products that will promote a society’s well being Technically, demand generation is a promotion strategy, yet
use of marketing techniques to achieve behavioral goals that condom does not receive equal attention and promotion as a whole. This does not mean that it is strictly non-commercial. its success is dependent on effective product, price and place
benefit a society’s well being as a whole. In this sense, it may when compared to the male condom and other contraceptive Rather, it tends to use commercial marketing techniques to strategies. Hence: understanding what your audience wants is of
benefit both the public and the private sectors simultaneously. methods. Furthermore, it tends to reach only a small proportion achieve a non-commercial goal, e.g. the improvement of public the utmost importance if you want to create demand effectively.
While programming for large-scale female condom promotion, of the population: those who visit public health centers for health through behavioral change. Hence, its primary aim is Developing a Marketing Mix strategy that includes all 4 P’s
you will surely come across these different sectors and their sexual and reproductive health matters, often women only. the improvement of a social good. This is what makes social ensures that you have considered all of the important questions
subsequent approaches to creating demand and access. B. Non-governmental organizations: International and marketing different from commercial marketing: the marketing prior to designing your promotion strategy. This is illustrated
national non-governmental organizations and community- seeks to benefit the target audience and the society as a whole below, with a focus on female condoms specifically.
based organizations may provide education and counseling without the explicit desire to make a profit. Social marketing
with regard to how to use the female condom and they may has been used extensively in international health programs, Product/solution: In female condom programming the social
distribute it. Often, a (international) donor or a United Nations especially for contraceptives and oral rehydration therapy marketing approach views the female condom as being the
agency, such as UNFPA, has contracted these organizations (ORT). solution for a range of sexual and reproductive health problems,
to conduct female condom programming and to distribute such as unintended pregnancy and Sexually Transmitted
the female condom for free. In many of these cases, female Characteristics of a social marketing approach: Infections (STIs), including HIV/Aids. The target audience must
condom programming is catering to specific groups only and not • It offers a solution for a public (health) concern be convinced that the product offered is a good solution for a
targeting the population at large. • It focuses on behavioral change public health concern.
• It seeks to benefit individuals and the society as a whole
• It is not about making a profit
2.2 Commercial, for profit • It creates demand for a certain product that will alleviate the
A. Private sector: Players in the private sector sell the female public concern, by way of an adapted marketing strategy Did you know...
condom for a profit. These may include shop owners, drug store • It increases access to this product because it is being Hair dressers themselves are models on the campaign
owners, pharmacists, hotel owners, bar owners, barbers and carefully marketed posters?
Female condom demonstration in Nigeria hairdressers. They sell the female condom at a higher price • It may offer the product at a subsidized price, although this
than what they paid for it. These commercial sales may be is not strictly necessary (depending on your assessment of
supported by an attractive (re)branding campaign that attracts price versus benefits)
many customers to make the business profitable. In the case • It applies a bottom-up approach by addressing the needs
Did you know... of the male condom, this is a very common approach. When it and desires of your target audience(s)
... That in Nigeria, the main users of the female comes to the female condom however, the commercial approach
condom are married women and men? is still underdeveloped. This can be explained by the fact that it
is a fairly new product, still largely unknown by large groups of
people, relatively expensive, and therefore not (yet) profitable.
The fact that the product offers a solution to health problems into their stock because of the small profit they will be able female condom as a contraceptive method, how to use it, and As for the commercial for-profit channel, stakeholders may
alone does not guarantee that people will actually buy the to make when selling it. At the same time, constant advocacy how to negotiate its use. Emphasis should be placed on sharing assist in the normalization of the female condom when it is
product. You should therefore make sure to develop a product efforts are needed towards the producers of female condoms information about the female condom, because you want to increasingly available at day-to-day places like convenience
strategy for people to become attracted to the female condom. for them to lower their prices in order to increase availability increase the knowledge and skills of female condom users. The stores, shops, bars, and supermarkets. The fact that the female
Inherent to the product strategy should be the positioning of the and uptake at community level. 63 focus of promotion is on creating and sustaining demand for the condom is not widely known as of yet, may cause the private
product and the package design: product. Attractive branding campaigns, packaging and media sector to be reluctant to invest in female condoms as it is
involvement will contribute to this goal. In your promotion primarily geared towards making a profit. When demand for the
Positioning refers to how the target audience perceives strategy, you will identify the target audiences, messages and female condom is created through social marketing, people are
the female condom. If, for example, women think of it as channels of communication. more likely to go to these day-to-day places to ask for and buy
uncomfortable, you may decide to re-position the product the female condom. Therefore, investing in the capacity building
as pleasurable. When re-branding the female condom you The 4 P’s can be complemented with another ‘P’: Package: of the private sector staff, demonstrating the market potential of
should ask yourself: what makes this brand different from other the product to them and making sure that they convey accurate
brands, and how is it unique? Package design is related to the positioning of the product. messages about the female condom when selling it is the way to
Sales may increase because people are attracted to the go. This would be part of your “place” strategy.
look, feel, sound, and smell of a product. Later on, in your
promotional strategy, you will be able to use the concrete It is important that there is continuous dialogue and
Did you know... aspects of your product strategy regarding the positioning and collaboration between the different sectors. National
...That some female sex workers in Nigeria are paid packaging of your female condom.64 government may be involved in the implementation of the
more money because the men like it that they do socially marketed female condom. Vice versa, social marketing
not feel the female condom (it feels more natural) organizations may help in building the capacity of government,
(compared to the male condom)? public sector staff, and private sector staff in promoting the
Taiya Ebijan in front of his cosmetic store in Lagos, Nigeria, where he Did you know... female condom as a contraceptive method as mentioned above.
sells female condoms ...That hairdressing salons sell more female condoms Collaboration may also exist in procuring the female condom or
than CBOs? in using each other’s distribution networks.
Price/Value: Essentially, a female condom is more expensive Place/Access: Female condoms need to be at the right place at
than a male condom due to the currently low overall production the right time, close to the day-to-day places that the (potential) The different sectors complement each other in many ways and
volume: there are simply fewer female condoms being user visits already for other purposes, to make sure that users social marketing can contribute to the overall strengthening of
produced than male condoms. For many women and men, the have access to the product. It is important that both men and the sectors so that they are better equipped to create demand,
price of a female condom forms an obstacle to buy and use it. women have the option of buying the female condom in a place 4. Complementarities and collaboration increase access, and make the female condom available to as
Social marketing of the female condom provides a subsidized that is both convenient and relatively private, so that they feel Social marketing strategies may be aimed at both the public and many people as possible. 65
and high quality female condom, up to the level of what users comfortable buying it. Determining what would be appropriate the private sectors in order to create demand for the female
want to pay for it. A “willingness to pay survey” can help you places, requires you to assess your target audience’s habits: condom. At the same time, when the public and private sectors
to determine the price that would likely be acceptable to your are strengthened in providing the female condom, as well as
target audience. In the case of the female condom, adapting • Where do they go regularly? What would be a safe the related education and counseling, access to the product Did you know...
the price to make the female condom affordable will enable environment for them to be educated about the female will improve. Hence, the two different sectors—public and ...In the first two years of the female condom
you to reach out to people who would never buy and use the condom? private—need to be strengthened to create continued access to programme in Nigeria, over 900,000 female condoms
female condom when they perceive it as being expensive. In • Where do they want to have access to the female condom? the female condom for men, women and couples. The different were sold?
other words: people may want to pay something if they are • Where do they think about or make choices that impact sectors will complement each other and you can find many ways
convinced that the female condom benefits them. If the female their female condom use (e.g in a bedroom, pharmacy, bar, to collaborate with both meaningfully.
condom is too expensive, the price will outweigh the benefits of brothel) and how can you intervene appropriately at those Did you know...
using it. The right price is about finding the appropriate balance moments of choice? In working with the non-commercial not-for-profit sectors, ...That between 2005 and 2009 care sales increased
between cost and benefit. Price, however, is not only monetary: such as public health, it is helpful to invest in a dialogue with by 135%?
it can also be about time, effort, shame, and comfort. This is Place strategies also include methods of reaching the consumer: the relevant public service stakeholders in order to map
absolutely critical to any social marketing strategy, even more so from warehouses to outlets and peer educators. The staff and existing difficulties regarding female condom promotion and
for female condoms, where the intangible, non-monetary costs peer educators need training in creating demand and being distribution. This will help to jointly develop short-term and
are often very high as people need to make a bigger effort to accessible, e.g. by extending the opening hours of outlets or by long-term strategies to finding solutions for these problems.
find the female condom and, even then, they may feel ashamed peer educators being highly mobile so that they may actively Health personnel may not be trained adequately or does not
to buy it. approach the consumer. have the necessary demonstration and promotional tools.
Therefore, it is important to consider the need to build the
Not only will a subsidized female condom enhance sustained Promotion/Information: When promoting the female condom, capacity of health providers and other relevant public servants
repeated use of the product by women and men, sellers of the peer educators use specifically designed communication tools in this regard, as well as providing training sessions concerning
product are also more willing to integrate the female condom to share information about sexual and reproductive health, the promotion and the accurate and consistent use of the female
64 This is more elaborately discussed in the chapter 4: How to communicate with potential users
63 Studies like the “willingness to pay” study can be integrated into other research activities described in this implementation guide. 65 See Bibliography and Further Reading for more information on demand creation for female condoms
Annex 1: Focus Group Discussion Guide for current
users and non-users of the female condom66.
FGD Guide for the Female Condom Mid-Evaluation. 6. Media listenership This has been a very interesting discussion….
Discussion relating to guide for current users of female condom Have you ever listened to any media campaign on the female
condom? Clarify unclear points, especially those that were made at the
beginning when the respondents may have felt uncomfortable.
Warming up and explanation 2. Profile of female condom user • Radio/TV Station CLOSURE
Who do you think should use the female condom? • Message recollection Those are all the questions I have for you today. The information
Introduction • How many times (estimated times) have they heard about the you gave us has been very useful. Thank you very much for
Welcome to [mention the venue] where we are going to discuss Probe for: detailed reasons in each case. campaign. participating in the survey and the interview.
the use of the female condom. We are happy that you were • Ask for age group (18-29; 30-45) of female condom users. • IPC shows
able to spare some time to come and take part. Let’s begin by • Whether users are young or old. • Meetings
introducing ourselves. My name is…., my colleagues names • If it is considered old-fashioned or trendy.
are…… We would like you to introduce yourselves too. Tell us • Users: Profession; working class, non-working class; traders. 7. Problems regarding the use of FC2
your names or nicknames to be used during the discussion. • Poor, middle class or rich.
• Urban or rural use. Probe for:
B. Purpose • Literate or illiterate? • Myths
We will be discussing and sharing our opinions in relation to the • Misconceptions
use of condoms to improve maternal and reproductive health. • If stigma is attached to use.
We are interested in all your ideas, comments and suggestions 3. Usability • Fear of spousal/partner disapproval
on how best we can improve this product. All information will All of us here are users of FC2. What are the benefits of using the • Male involvement/cooperation
be treated as confidential. Elegance female condom? • General suggestions and recommendations for
C. Explain the ground rules for discussion Probe for: • Any other problems.
This is a friendly discussion so there are no right or wrong • Comfort of use.
answers. Everyone should feel free to express his/her opinion. • If it is easy to carry in purse, bag, etc.
We would like to have one speaker at a time with no side
discussions during the session. Anyone can contribute to the FGD Guide for the Female Condom Mid-Evaluation.
discussion at any time. You should feel free to agree or disagree 4. Accessibility Discussion Guide for Non-Users of the Female Condom
with one another in a friendly manner. Refreshments will be Where do you buy or get female condoms?
served after or halfway during the discussion.
Probe for: Warming up and explanation with one another in a friendly manner. Refreshments will be
Explain and seek permission to record the discussion. • Type of store/place; PPMV, private hospital/clinic, served after or halfway during the discussion.
government hospital, etc. Introduction
Ice breaker • Estimated distance from house to place of purchase (in Welcome to [mention the venue] where we are going to discuss Explain and seek permission to record the discussion.
What do we know about the female condom? minutes). the female condom. We are happy that you were able to spare
some time to come and have this discussion. Let’s begin by Ice breaker
introducing ourselves. My name is…., my colleagues names What do we know about the female condom?
1. Knowledge on the female condom 5. Affordability are…… We would like you to introduce yourselves. Tell us your
What do you know about the female condom? Do you think the female condom is affordable? Ask for detailed names/nicknames to be used during the discussion.
reasons for either yes or no. 1. Knowledge on female condom
Probe for: B. Purpose What do you know about the female condom?
• Name of the female condom they know. Probe for: We will be discussing and sharing our opinions in relation to
• What it looks like (description). • Price. the use of condoms to improve maternal and reproductive Probe for:
• When it should be used. • Preferred price and reasons. health. We are interested in all your ideas, comments and • Name of the female condom they know.
• How it is used (inserted). suggestions on what are the best ways to improve this product. • What it looks like (description).
• Who inserts it. All information will be treated as confidential. • When it should be used.
• Protection against STIs. • How it is used/inserted.
• Protection against HIV. C. Explain the ground rules for the discussion • Who inserts it.
• Protection against unwanted pregnancy. This is a friendly discussion so there are no right or wrong • Protection against STIs
• How it is disposed of. answers. Everyone should feel free to express his/her opinion. • Protection against HIV
We would like to have one speaker at a time and no side • Protection against unwanted pregnancy
discussions during the session. Anyone can contribute to the • How it is disposed of.
discussion at any time. You should feel free to agree or disagree
66 From SFH 2011, How far have we gone and where do we go from here? Report of the Female Condom Mid-term Evaluation in the Edo, Delta and Lagos States of Nigeria.
Annex 2: Example of a Female Condom
Program Goal and Objectives
2. Profile of female condom user 5. Affordability
Who do you think should use the female condom? Do you think the female condom is affordable? Ask for detailed Female Condom Program in Nigeria67
reasons for either yes or no.
Probe for: (ask for detailed reasons in each case)
• Ask for age group (18-29; 30-45) of female condom users. Probe for: Goals • Reduction in the number of unwanted pregnancies.
• Whether users are young or old. • Price. • Reduction in the incidence of STIs and HIV infection.
• If it is considered old-fashioned or trendy. • Preferred price and reasons.
• Profession; working class, non-working class; traders.
• Poor, middle class or rich? Objectives • Increase in the demand of the female condom.
• Urban or rural use. 6. Media listenership • The female condom is publicly accepted as a commodity that enables women to exercise
• Users literate or illiterate. Have you ever listened to any media campaign on the female their sexual and reproductive rights.
condom? • Female condoms are widely available at convenient places, at all times and at an
3. Usability Probe for:
All of us here are non-users of FC2. What are the reasons why • Radio/TV station
we don’t use the female condom? • Message recollection Strategy: Project components • Create enabling environments.
• How many times (estimated times) have they heard about the • Create demand.
Probe for: campaign? • Inclusion of the female condom in existing programmes and service packages.
• Myths • IPC shows • Managing the supply chain.
• Misconceptions • Meetings
• If stigma is attached to use.
• Fear of spousal/partner disapproval. This has been a very interesting discussion….
• Male involvement/cooperation.
• Not comfortable to use. Clarify unclear points, especially those that were made at the
• Not easy to carry in purse, bag, etc. beginning when the respondents may have felt uncomfortable.
• Any other reasons.
These are all the questions I have for you today. The information
4. Accessibility you gave us has been very useful. Thank you very much for
Where can one buy or get female condoms? participating in the survey and the interview.
• Type of store/place; PPMV, private hospital/clinic,
government hospital, etc.
• Estimated distance from house to place of purchase (in
67 Society for Family Health Nigeria, 2008.
Annex 3: Communication Strategy Outline 68
Annex 4: Outline of an Advocacy Plan
Name of advocacy action plan:
Female Condom Promotion
Audience Communication Key Messages/ Communication Activities
Objectives Themes Channels Overall goal:
Women and men of Increase the number Family Planning Inter-Personal • Branding: logo
reproductive age of women and men Communication and tagline that
having accurate HIV prevention summarize female
knowledge of the Sensitization condom and its
female condom. Reliability benefits.
Increase the number Empowerment • Peer education
of women and men Branding campaign
buying the female Health • T-shirts/promo items
condom. Mass media with brand
Pleasure Target audience:
• Road shows/drama
• National TV
advertisements Support Groups:
• Female condom
Hairdressers Increase the number Family Planning Inter-personal • Branding: logo
of hairdressers communication and tagline that Message and channels of communication: Resources needed:
who have accurate HIV prevention summarizes female
knowledge of the Visits condom and its
benefits of the Health benefits.
female condom. Mass media
Reliable • Posters, flip charts,
Increase the number Training T-shirts
of hairdressers who Empowerment
become peer • Training Activities + Time and place:
educators and sales Profit
agents. • Toolkit with female
for use during
Young people etc. ……… ……… ……… ………
Agreements on follow up: Strategy: Project components
Media ……… ……… ……… ………
Health care workers ……… ……… ……… ………
68 Please note that this is a simple example of a communications plan. This is based on Zimbabwe Ministry of Health, National Communications Strategy for Male Circumcision.
Abbreviations Bibliography and further reading
AIDS Acquired Immune Deficiency Syndrome 1. Bibliography
ACMS Association Camerounaise pour le Marketing Social
CBO Community Based Organization Center for Health and Gender Equity. Female Condoms and U.S. Foreign Assistance: An Unfinished Imperative for Women’s Health.
cm Centimeter Washington, DC: Center for Health and Gender Equity, 2011
CSO Civil Society Organization
DJ Disk Jockey Fontanet AL, Saba J, Chandelying V, et al. Protection against sexually transmitted diseases by granting sex workers in Thailand. the choice
FAQ Frequently Asked Questions of using the male or female condom: results from a randomized controlled trial. AIDS 1998;12(14):1851–59.
FBO Faith Based Organizations
FC Female Condom Gollub EL. The female condom: tool for women’s empowerment. American Journal of Public Health 2000;90(9):1377–81.
FC2 Female Condom 2 Policy Project (1999): Networking for
FDA (US) Food and Drug Administration
FEFO First Expired First Out Policy Change: An Advocacy Training Manual
FGD Focus Group Discussion http://www.policyproject.com/pubs/AdvocacyManual.cfm
FP Family Planning
GPI Girls’ Power Initiative IPPF (2009) Generating Political Change, using advocacy to create political commitment.
HIV Human Immunodeficiency Virus http://www.ippf.org/en/Resources/Guides-toolkits/Generating+political+change.htm
IEC Information, Education, Communication
IPC Inter-Personal Communication MenEngage Global Alliance: http://menengage.org/.
KAB/P Knowledge, Attitude, Behavior/Practices
LAPO Lift Above Poverty Organization UNAIDS (2010), Report on the Global Aids Epidemic. http://www.unaids.org/globalreport/
M&E Monitor and Evaluation
MDGs Millennium Development Goals
MICS Multiple Indicator Cluster Surveys 2. Further reading on female condom programming
MINIMIDT Minister of Industries, Mines and Technological Development
MINPROFF Minister of Woman Empowerment and the Family This guide for planning and programming in relation to the female condom is intended to help design, implement, and monitor the
MoU Memorandum of Understanding introduction of the female condom in different settings. It is developed by UNAIDS and the WHO:
N.B. Nota bene http://data.unaids.org/publications/IRC-pub01/jc301-femcondguide_en.pdf
NGOs Non-Governmental Organizations
ORT Oral Rehydration Therapy This guide of UNFPA contains a 10-step strategic approach to scale up culturally appropriate and effective efforts towards
PLHIV People Living with HIV comprehensive condom programming:
PMTCT Preventing Mother To Child Transmission (of HIV) http://unfpa.org/webdav/site/global/shared/documents/publications/2011/CCP.pdf
PSI Population Services International
PSM Procurement and Supply chain Management On this UNFPA website you can find useful information, facts and publications about comprehensive condom programming with regards
SFH Society for Family Health to HIV/AIDS prevention:
SMS Short Message Service http://www.unfpa.org/hiv/programming.htm
SRH Sexual and Reproductive Health
SRHR Sexual and Reproductive Health and Rights UNFPA, FHI and the Inter Agency Task Team on condoms. Creating demand for male and female condom use (forthcoming, planned for
STI Sexually Transmitted Infections fall/ winter 2011; title might still change)’.
SWAA Society for Women and AIDS in Africa
ToT Training of Trainers Conducting a Situational Analysis
ToR Terms of Reference Chapter Process
UAFC Universal Access to Female Condoms (Joint Programme)
UN United Nations This tool on situation analysis is useful when examining the availability and quality of family planning and reproductive health services
UNFPA United Nations Population Fund in a large area, e.g. a country, or in a smaller area, e.g. a region or city:
VCT Voluntary Counseling and Testing http://www.unfpa.org/webdav/site/global/shared/documents/publications/2010/srh_guide/tools_situationanalysis.html
WHO World Health Organization
This document helps to monitor progress towards the goal of universal access to sexual and reproductive health at country level by
presenting a set of indicators within a clearly specified framework:
This tool aims to provide a guide for assessing linkages that can be adapted as needed to regional or
national contexts based on a number of factors. It can also contribute to the development of action-plans to strengthen SRH and HIV
linkages. It is available in five languages:
Baseline studies Communication Strategies
Chapter 1: Process Chapter 4: How to communicate with potential users
MICS is a tool for collecting and analyzing data. It is used to fill data gaps for monitoring the situation of children and women by way of This matrix made by CARIMAC and the University of the West Indies can be of use when comparing types of media. It shows the
an international household survey. http://www.unicef.org/statistics/index_24302.html advantages and disadvantages as well as cost estimates of many types of media:
Monitoring and Evaluation (M&E) This chapter, written by UNESCO, (S. Ganguly), describes different ways to communicate through media, different communication
Chapter 1: Process systems and several communication strategies:
A comprehensive handbook on monitoring, evaluation and learning, including a tool to assess capacity: http://www.ippf.org/NR/
Chapter 6: Advocacy towards decision makers
Chapter 4: How to communicate with potential users This toolkit contains a step-by-step approach, leading you through the advocacy process. It gives concrete action points and checklists to
help you to carry out your advocacy work most effectively:
This framework provides an IPPF perspective on peer education and is meant to assist in ensuring peer education programmes are as http://www.ippf.org/NR/rdonlyres/E4ED7799-7C00-40C2-9B0C-81C660C9CCE6/0/From_advocacy_to_access.pdf
effective as possible. It is available in English, French and Spanish:
http://www.ippf.org/en/Resources/Guides-toolkits/Peer+Education+Framework.htm This handbook uses case studies to describe how to advocate for sexual and reproductive health and rights:
IEC material This training manual is very useful for advocacy planning. Policy Project (1999): Networking for Policy Change: An Advocacy Training
Chapter 4: How to communicate with potential users Manual: http://www.policyproject.com/pubs/AdvocacyManual.cfm
This IPPF checklist helps to create effective Information, Education and Communication (IEC) materials for young people with regard to This Change Agency tool is helpful in explaining how to asses, step by step, the social and political context within which a campaigning
SRHR. It includes a list of elements which should (or should not) be used in developing IEC materials: strategy is developed, creatively considering allies, opponents, targets and constituents:
Chapter 8: Creating demand, increasing access
Frequently Asked Questions
Female Condom Promotion • think that their partners prefer the female condom because Can the female condom add pleasure during sex? female condom during sexual intercourse. Fears that the female
it can give them greater pleasure. condom might enter the womb/cervix, are, however, totally
Why should the female condom be universally • For men the sensation is closer to that of sex without a Yes, the pleasure one experiences depends on the type of unjustified. Both the outer and the inner rings and the sponge(s)
accessible? condom, because female condoms do not fit tightly around female condom used and on your personal preferences. Since prevent this from happening.
the penis as male condoms do. all female condoms offer dual protection, one can relax and
The female condom offers women and men dual protection. • Many users believe that female condoms are stronger and one does not need to worry about becoming pregnant or getting
The female condom protects against all sexually-transmitted thus safer than male condoms, which helps them to relax and a sexually transmitted infection such as HIV while having sex. Where can you buy female condoms?
infections (also on the outside of the vagina) including HIV. enjoy sex. Some couples have found that the inner and outer ring of the
Furthermore, it prevents pregnancy. 215 million women in • Although female condoms were not designed for anal sex, FC2 adds pleasure to the sexual experience; the same goes for This differs per country. In some countries, the female
developing countries would like to use contraception but have some couples prefer them to male condoms when having the outer ring of the Reddy and Cupid condoms. Some men condom can be bought in pharmacies, commercial outlets,
no access to it. anal sex. prefer the female condom to the male condom because it does at hairdressers, etc. Sometimes the female condom is also
not fit tightly around the penis. Also the sponge in the Reddy distributed in the public sector. Unfortunately, there are often
The female condom contributes to meeting international Note that a female condom and a male condom should not be condom can add pleasure for the man. Since the material used stock-outs making it difficult to obtain condoms.
commitments on development. The Millennium Development used at the same time! to make the FC2 is not latex but nitrile, it conducts heat, which
Goals (MDG’s) on maternal and child mortality and morbidity can make sexual intercourse feel very sensitive and natural.
rates, as well as HIV/AIDS will not be attained if existing Which models of female condoms are available?
technologies, such as the female condom, remain out of reach Why is the female condom relatively expensive?
for those women who need it. Who would you recommend should use the female At the moment, the FC2, the VA w.o.w.® female condom (also
There are three main reasons for the current price level of the condom? known as: Reddy/V’Amour/L’amour), and the Cupid ltd. Latex
Gender inequality is an important driver of the HIV epidemic; female condom: Female Condom are available. Not all three varieties are yet
the feminisation of AIDS has become a reality. Women make The female condom is suitable for all women and men. For available in all countries.
up more than half of the 33 million people worldwide currently Use of Materials some couples, it is a huge advantage that it can be inserted even
infected with HIV. In Sub-Saharan Africa, 76% of HIV-positive More materials are needed for the production of the female before foreplay (and not in the ‘heat of the moment’). Just like
youth are female. Women and girls face the consequences of condom (compared to that of the male condom). Furthermore, the male condom, you need to practice using it. Therefore, we
unprotected sex and bear a huge burden through unwanted the material itself can be more expensive. The FC2, for example, advise you to try it several times and then judge whether the
pregnancy and the risk of infection. The female condom is the is made of nitrile, which is more expensive than latex. The female condom works for you.
only device that offers dual protection, is women-initiated and packaging and the placing of rings and/or the sponge make the It can be used:
is available now. Universal access to female condoms should production process more complicated and labour-intensive With other contraceptives including the pill and intra-uterine
therefore be a priority. and thus more expensive. More research and development is devices
needed to work towards cheaper female condom types. During menstruation
After having recently given birth FC2 Female Condom
What is the advantage of the female condom over Economies of scale During menopause
the male condom? Female condoms are not produced on a very large scale. • Made of Nitrile, a synthetic latex.
Because relatively few female condoms are produced, their • Conducts heat.
Female condoms offer more flexibility regarding the timing of price is higher. For example, roughly 423 male condoms Does the female condom make noise? • Has two rings to keep it in place.
insertion and removal. The condom can be inserted prior to are produced for every female condom. If more large-scale • Lubricant included
intercourse and even before foreplay (the length of time before female condom programs were to be implemented and the None of the female condoms are noisy. FC1 (the first FC model • Since it is made of synthetic material, it is also suitable
intercourse and foreplay depending on the type of female procurement and production of female condoms were to produced by the Female Health Company) was made of rather for people with a latex allergy. It is also not affected by
condom. However, latex is weaker and deteriorates faster. increase, the price would decrease. thick polyurethane and was known for the “crispy” sound. temperature and humidity so it can be stored almost
Insertion should, therefore, not take place too long before sex), The FC1 has, however, been replaced by the FC2 (the newer FC anywhere.
compared to the male condom which needs to be put on just Dominant position of one manufacturer model of the Female Health Company) almost anywhere. The
before intercourse, “in the heat of the moment”, so to speak. The FC2 is produced by the manufacturer Female Health FC2 is made of nitrile, which is a synthetic latex that feels very
Female condoms (compared to the male condom) give women Company. This condom is the only one on the market with natural. It adapts to body temperature. The Dr. Reddy and Cupid
more power to negotiate safer sex and a greater sense of control World Health Organisation (WHO) certification. Other condoms are made from latex, which is not noisy. The PATH
and safety. Many women find them easier to use because they: manufacturers have not yet fulfilled all the requirements of Women’s condom is made of such thin polyurethane that you
• can initiate their use; the WHO certification procedure. This means that only FC2 is can hardly hear it.
• have greater ownership of the female condom, since they purchased by donor agencies and international organisations
can insert it themselves, even before foreplay; which enables the Female Health Company to dominate
• do not require the same degree of co-operation from their the market and keep the price artificially high. Introducing How do you insert and remove the female condom?
partners, since the latter do not need to put it on; competition into the female condom market would help to lower Reddy Female Condom
• do not have to repeatedly negotiate use, as with the male unit prices. Therefore, it is important that more condoms are The way to insert and remove the female condom after sexual
condom, particularly at the moment when it must be prequalified (certified) by the WHO. intercourse depends on the type of female condom you are • Made of latex (rubber).
inserted; using. In general, any female condom is not difficult to use • Has one triangular ring and
• think that their partners prefer to transfer responsibility to although it does require some practice. It is recommended one sponge to keep it in place.
them; that first-time users review the detailed instructions, and take • Lubricant included.
time to practice insertion and removal before actually using a
Why is it important that there are different types of Please see below explanations of terms used in the context of Lead organization
female condoms on the market? this guide. The lead organization is part of the operational team and
coordinates the program. It may have regional teams or
Cupid Female Condom There are two reasons why there should be different types offices for overseeing regional activities. It is responsible for
of female condoms on the market. First, people differ and Advocacy the operational design, implementation and monitoring of
• Made of latex (rubber). preferences differ. Therefore, it is important that people can Advocacy is a process to get support, promotion and funds for program activities vis-à-vis the donor(s). Financial and narrative
• Has one octagonal ring and one choose a condom that fits their preferences as best as possible. the female condom by influencing different decision makers, reporting is also the responsibility of the lead organization. It
sponge to keep it in place. If there is only one female condom on the market, and a person such as community leaders and other gatekeepers, government coordinates and communicates with several partners, from the
• Lubricant included. does not like using that particular type, it is important to offer and institutions. A positive attitude towards the female condom supervisory body, to CBOs and peer educators.
an alternative. and its benefits therefore needs constant sensitization and
engagement of influential leaders in the community.
Second, different types of female condoms can lead to lower Large-scale female condom programming
prices. Currently the FC2 female condom is the only condom Large-scale female condom programming reaches out to the
widely available because it is the only female condom Civil Society Implementing Partners entire (sexually active) population in providing a choice in
approved by the World Health Organisation. This is needed Civil society implementing partners include e.g. community- family planning and contraceptive methods. This programming
Which developments in the field of female condoms as a prerequisite for UN organisations, the most important based and faith-based organizations, female condom peer aims to make the female condom available, affordable and
are foreseen in the future? distributor of female condoms. If other condoms are tested and promoters, women, men and youth group leaders who have accessible for all.
approved by the World Health Organisation, there will be more close connections with a community and its gatekeepers and
The Dr. Reddy condom and the Cupid condom have been competition between the manufacturers of condoms. More consequently can gain easy access to target groups and create
approved by the European Commission, but not yet by the competition will lead to lower prices of female condoms and acceptability of the product. Lead trainers
World Health Organisation. If advocating for the testing of thus wider availability. Lead trainers disseminate their knowledge to peer educators,
these condoms at national Food and Drug Administrations or at and support them in their activities in the communities.
the World Health Organisation is successful, they will become Community leaders Lead trainers take part in a Training of Trainers by the lead
much more widely available than they are today. Currently, the What kind of lubricant can be used with the female Community leaders are local government leaders and religious organization. These lead trainers may belong to organizations
Woman’s Condom, developed by a global health non-profit condom? leaders. that have a wide reach in reproductive health, family planning
organisation, PATH, is going through the required process for its and HIV interventions. They can also be strong influential
introduction on the market. The FC2, Dr. Reddy and Cupid condom come pre-lubricated. It individuals in a community who support the project.
is of course possible to use extra lubrication on the inside of Commercial (profit) sector:
the female condom or on the penis. With the FC2 you can use Commercial (profit) players may include shop and drug-store
water-based silicone as well as oil-based lubricants. With the owners, pharmacists, hotel and bar owners and barbers and Peer educators
Dr. Reddy and Cupid condoms you can only use water-based hair stylists who sell the female condom for a profit. They Peer educators play a role in educating their “peers” in female
lubricants or silicone lubricant, not oil-based lubricants. This is sell it for the wholesale price plus a margin. This commercial condom use. Education about the female condom requires
Woman´s Condom because if you use oil-based lubricants with latex condoms they approach is still underdeveloped in relation to the female a safe environment and a delicate approach to (potential)
may tear. If you want to keep it simple, only recommend the use condom. The reason is that the female condom is a fairly new users. The target group needs to feel safe and comfortable in
• Made of very thin polyurethane. of water-based and silicone lubricants with female condoms. product, largely unknown, expensive and therefore not (yet) raising questions and concerns about female condom use. Peer
• Can be inserted like a tampon. profitable. educators are vital in female condom education and counseling.
• The little cap will dissolve within They may include CBO staff, hairdressers and barbers, or
minutes when in contact with any people living in communities you are able to target because
liquid (e.g. bodily fluid or lubricant). Drug stores the were identified by the lead organization’s technical staff.
Drug stores are often small merchandise kiosks where they also They are trained and equipped with educational tools, female
sell some non-prescription health items. condoms and possibly a demonstration model.
Gatekeepers Public sector
Gatekeepers are opinion leaders like chiefs, traditional rulers, Public sector partners include, for example, health and family
Woman´s Condom and other influential people. planning clinics, (community) health workers, infections clinics,
support groups for People Living with HIV, antenatal, PMTCT
• The condom will unfold automatically and postnatal clinics and testing and counseling centers.
on penetration. Inter-personal communication
• Little sponges on the side keep IPC is a face-to-face method that takes place between the
the condom in place. educator and the potential user in which there is inter-personal Private sector
• Lubricant is included in a separate dialogue about the female condom, and opportunity for the Private sector partners include, for example, hairdressers and
sachet in order to protect the cap. user to voice concerns and ask questions. barbers, pharmacies and drug stores, sex worker networks,
manicurists, hotel owners, private clinics, organizations
employing numerous men and women and various female-
oriented sales points.
Procurement and Supply chain Management (PSM) Social Marketing This publication was produced by the Universal Access to Administrative support was provided by Nelleke Buijs, Sabine
Procurement and Supply chain Management is the process Social marketing is a marketing approach that is applied to the Female Condoms (UAFC) Joint Programme. It was written by Knopper and Kathy de Kruijf of Rutgers WPF.
of purchasing, in this case female condoms, from the promotion of products that promote a society’s wellbeing as Hilde Kroes of Rutgers WPF, edited by Steffie Verstappen and
manufacturer, shipping them to a particular country, storing a whole. It tends to use commercial marketing techniques to translated into French by Roger Issa Coulibaly. The layout of We are thankful for the contributions, suggestions and other
them in warehouses and depots, and organizing the logistics to achieve a non-commercial goal, e.g. the improvement of public this publication was designed by Dox Imagemakers, under the feedback of third parties:
get the female condoms to outlets, CBOs, public-health centers health through behavioral change. supervision of Annet Neijmeijer (Rutgers WPF). • Louise Lee-Jones – Marie Stopes International (MSI)
and peer educators. The overall goal of PSM is to make sure that • Beth Skorochod – Population Services International (PSI)
the product is moving continuously, i.e. that all segments of the The UAFC Joint Programme could not have realized the • Sarah Shaw – International Planned Parenthood Federation
supply chain are continuously stocked. Supervisory body publication without the extensive contributions from Society (IPPF)
The operational team can be supported by a supervisory of Family Health (SFH) Nigeria, Association Camerounaise pour • Dieneke ter Huurne, David Smith, Doortje Braeken, Ilka
body that oversees program implementation. The supervisory le Marketing Social (ACMS), PSI Zimbabwe, PSI Mozambique Rondinelli, Jennifer Woodside, Jolene Innis, and Sarah Shaw
Re-branding body not only advises on how to maximize impact of the and Girls’ Power Initiative (GPI) Nigeria, and in particular the - International Planned Parenthood Federation (IPPF)
The FC2, for example, is branded as the FC2 by the Female implementation, it also has a strong advocacy component: following individuals who formed the Reading Committee: • Frederica Stines and Audacia Ray – International Women’s
Health Company. You can choose to rebrand the FC2 to fit members represent certain groups in society and have strong • Dorien Rhebergen – PSI Mozambique Health Coalition
in with the local context and target audiences. In Nigeria, networks. Especially with regard to the promotion of the female • Ifeoma Ideh – Society for Family Health Nigeria
Cameroon and Zimbabwe for example, only FC2s are sold, condom, such ‘champions’ acting as part of the governance • Lily Claire Ekobika – Association Camerounaise pour le In Cameroon for pre-testing this publication:
but they are rebranded as “Elegance”, “Protectiv” and “care” structure are important for the execution and sustainability of Marketing Social (ACMS) • Community Initiative for Sustainable Development
respectively. the project. • Lucie van Mens – UAFC Joint Programme Coordinator (COMINSUD)
• Patience Kunaka – PSI Zimbabwe • BALI Treatment Centre
• May Ikoghode – Girls’ Power Initiative Nigeria • Mey-low-D Foundation for Youth Edutainment
Sensitization sessions • Michèle Razanamparany – i+ solutions • OVERCOMERS
Sensitization sessions are group sessions, in which a peer • Nienke Blauw – Rutgers WPF • Youth Outreach Program (YOP)
educator addresses groups of people for example in the Many thanks to you all for your time, energy and inspiration.
market, in hospitals or during workshops or meetings. Group The activities described in this publication would not have been
sensitization sessions can be carried out in mixed female Other individuals contributed at different occasions throughout possible without the support of our donors and partners:
and male groups, but also in separate groups. This strategy the documentation and writing process:
creates interest in the product and is an effective method to • Victoria Archibong, Ifeanyi Okekearu and Mimi Sharon Ede The Hewlett Foundation
inform larger groups of people. The disadvantage is that the of SFH; Netherlands Ministry of Foreign Affairs
environment does not allow personal questions or concerns • Heyndricks Bile, Annie-Michèle Salla and Hervé Roger Danish Ministry of Foreign Affairs (DANIDA)
to be raised. The peer educator, who has been trained in Ngueche of ACMS Norwegian Ministry of Foreign Affairs (NORAD)
counseling, is available afterwards to address these personal • Gertjan van Bruchem and Monique Demenint of Oxfam Swedish Ministry of Foreign Affairs (SIDA)
issues. Novib Oxfam Novib
• Yvonne Bogaarts, Sille Jansen and Margo Bakker of Rutgers United Nations Population Fund (UNFPA)
• Jennifer Oboh - LAPO
• Maira Solange Hari Domingos – Fórum Mulher Mozambique;
• Margarida Guerra, Pathfinder International Mozambique
• Cobi Mars
• Sonny Onwuche Akoh
We are very grateful for your extensive contributions.
The Implementation Guide on Female Condom Programming does capacity building of technical health care personnel and Girls Power Initiative (GPI) Rutgers WPF
is based on the experiences of large- scale female condom community outreach; and PSI/Mozambique is strong in supply Girls Power Initiative (GPI) is an NGO located in four states of Rutgers WPF is a renowned expert centre on sexual and
programmes in four different countries: Cameroon, chain management and social marketing. All organisations are Nigeria focussing on empowering adolescent girls for social reproductive health and rights. Its activities are mainly carried
Mozambique, Nigeria and Zimbabwe. The programmes in actively engaged in Interpersonal Communication (IPC) to create action through skills training relating to sexuality, human rights, out in the Netherlands, Africa and Asia. Its aim is to improve
Cameroon and Nigeria are part of the Universal Access to Female demand and to familiarize people with the consistent use of life management and leadership from a gender perspective, sexual and reproductive health and rights throughout the world,
Condoms (UAFC) Joint Programme whereas the programmes female condoms. in this way promoting and protecting their sexual and specifically focussing on young people, women and vulnerable
in Mozambique and Zimbabwe are stand-alone programmes. The Consortium works in conjunction with the national Council reproductive health and rights. groups like the disabled or chronically ill. Rutgers WPF
Please find a brief description of each programme below: of HIV and the Ministry of Health on various fronts, including http://www.gpinigeria.org/ supports partner organisations and professionals in their work,
the approval of all IEC material. increasing their expertise on sexuality.
http://www.psi.org/mozambique Rutgers WPF evolved from the merger of the Rutgers Nisso
Care Initiative (PSI/Zimbabwe Female Condom Programme) Population Services International (PSI) Mozambique Groep, Dutch expert centre on sexuality, and the World
The care female condom programme is an innovative initiative Population Services International (PSI) is an international Population Foundation (WPF). This merger took place at the
focused on interpersonal communication (IPC) between women Universal Access to Female Condoms (UAFC) Joint NGO with headquarters based in the USA. PSI/Mozambique end of 2010. Rutgers WPF is a member of IPPF, the International
and their hair stylist, sex worker queens and their peers and Programme has been operating in Mozambique since 1994. The Planned Parenthood Federation.
women living in positive or discordant relationships. The The UAFC Joint Programme started in 2008 with the aim of organisation, supported by the Ministry of Health, is engaged www.rutgerswpf.org
programme was launched in 1997. Currently the initiative making female condoms accessible, affordable and available in the promotion of healthy behaviour amongst vulnerable
involves working with over 1,500 hairdressers, over 100 sex for all. Thus it would contribute to a decrease in new HIV populations. PSI works in the area of reproductive health, HIV/
worker groups and more than 50 People Living with HIV (PLHIV) infections, STIs and mistimed and unwanted pregnancies and AIDS, Malaria, Safe Water Systems and Nutrition. Society for Family Health (SFH)
support groups. enable women to exercise power over their own sexual and http://www.psi.org/mozambique The Society for Family Health (SFH), based in Nigeria, is a
reproductive health. foremost indigenous non-governmental organisation founded
At a national level, PSI Zimbabwe trains hairstylists, sex in 1985. SFH is dedicated to empowering Nigerians, particularly
worker queens and women living positively to discuss the The programme is an initiative of Oxfam Novib, Rutgers WPF, i+ Population Services International (PSI) Zimbabwe the poor and vulnerable to lead healthier lives. SFH supports
brand attributes of the female condom. Training also covers solutions, and the Netherlands Ministry of Foreign Affairs and PSI/Zimbabwe was established in 1996 to reduce the rate of HIV public health intervention efforts of the Federal Government
the benefits of using the female condom with demonstrations consists of three components: infections in Zimbabwe, prevent malaria and improve family of Nigeria, with specialisation in three key public areas
on how to use it correctly. The programme targets areas of 1. Research and Development, including procurement, planning practices using social marketing strategies. Between including HIV&AIDS prevention, Child Spacing and Maternal
high-risk activity such as Growth Points and border towns 2. Large-scale female condom country programmes in Nigeria 2008 and 2009, the programme added hygiene promotion and and Child Health (malaria and diarrhoea control). It deploys
and aims to open channels and train community outreach and Cameroon, implemented by the Society for Family home-based water treatment and male circumcision services to social marketing techniques through health communication,
agents. Community outreach activities are complimented by Health (SFH) and ACMS respectively, in cooperation with its portfolio. PSI works in close partnership with the Zimbabwe advocacy, research, community mobilisation, product sales and
mass media campaigns to help normalize the female condom, other civil society organisations, the government, UN Ministry of Health and Child Welfare and other stakeholders distribution which are carried out by over 350 employees in 16
minimize stigma and generate partner support for the product. agencies and the private sector and supervised by a national in order to reach vulnerable populations with health-related state offices spread across Nigeria’s six geopolitical zones.
Target groups are sexually active women aged 20-49 years steering committee and communication messages and products and services. http://www.sfhnigeria.org/
of age (primary target group – which is in turn segmented to 3. International advocacy, Linking & Learning and http://www.psi.org/Zimbabwe
maximize outreach) and male partners (secondary target group). Communication.
The PSI socially marketed female condom complements the The programme donors are Danida, the Netherlands Ministry of
public sector free distribution condom to achieve the total Foreign Affairs, The William and Flora Hewlett Foundation, Sida,
market condom distribution approach used in the country. The Oxfam Novib and Norad (for 2008).
socially marketed condom is distributed through private sector http://www.condoms4all.org
channels while the public sector condom is distributed free in
public sector institutions.
http://www.psi.org/Zimbabwe The following organizations have contributed to the
Female Condom Programme Mozambique Association Camerounaise Pour le Marketing Social (ACMS)
The Female Condom Programme in Mozambique is a three-year Set up in 1996, following an agreement between the government
programme, operational since January 2011. The programme of Cameroon and Population Services International, ACMS is
is currently being implemented in Maputo and Nampula an association under Cameroonian law. Its objectives are to
provinces by a consortium of three organisations: Fórum contribute with other health and development stakeholders in
Mulher, Pathfinder International and PSI/Mozambique. The the conception and the implementation of strategies to improve
overall goal of the programme is to contribute to the reduction the social welfare of Cameroonian populations.
of the number of HIV infections and unwanted/unplanned ACMS facilitates the population’s access to good information,
pregnancies among the sexually active population. services and quality products in the domains of HIV prevention,
The organisations within the consortium complement each malaria prevention, family planning, fight against diarrhoeic
other’s expertise in a very effective manner: Fórum Mulher diseases and reproductive health.
is very strong in advocacy, with a vast network of women’s http://www.acms-cm.org/
organisations under its umbrella; Pathfinder International
92 Dutch MP Kathleen Ferrier makes her statement on a Paper Doll